Our cardiac meds – in real life, not just in studies

by Carolyn Thomas    @HeartSisters    September 16, 2018

If you – like me – have had a heart attack, you are now likely taking a fistful of medications each morning, everything from anti-platelet drugs to help prevent a new blockage from forming inside your metal stent to meds that can help lower your blood pressure. All of these cardiac drugs have been studied by researchers before being approved by government regulators as being safe and effective for us to take every day.

But one particular study on this subject published in the Journal of the American College of Cardiology(1) raised a unique point:

“Little is known about the benefits and risks of longterm use of cardiovascular drugs. Clinical trials rarely go beyond a few years of follow-up, but patients are often given continuous treatment with multiple drugs well into old age.”  

Continue reading “Our cardiac meds – in real life, not just in studies”

Yale Heart Study asks why we wait so long before seeking help in mid-heart attack

Did you know that even when experiencing textbook heart attack symptoms (like my own chest and left arm pain), people wait an average of four hours before seeking medical help?  The tragic irony is that heart patients who do best are those who can be treated within the first hour of those initial acute symptoms.

Heart attacks are dangerous and scary – so why do so many of us suffer silently for hours (and in many cases, far longer?)  This treatment-seeking delay behaviour concerns many researchers, including Yale University’s Dr. Angelo Alonzo. He told me:

“Ask people what they would do if they had a heart attack and, of course, they’d all  insist they would seek care immediately.  Sounds easy!  But in reality, few people actually do drop everything to get help.”    Continue reading “Yale Heart Study asks why we wait so long before seeking help in mid-heart attack”

Are women being left behind in cardiac research?

I was interviewed by Catherine Morgan at Blogher after the report called Heart Device Studies Still Leave Women Out of Equation was published in the March issue of the journal, Circulation. Catherine asked a number of questions about my take on Dr. Rita Redberg’s findings in this research. For example, one of her questions was:

“How concerned should women with heart disease be about this latest report?”   Continue reading “Are women being left behind in cardiac research?”

Gender differences in heart attack treatment contribute to women’s higher death rates

The alarming results of a study undertaken in France highlighted serious gender differences in cardiac treatment of men and women.  These shocking differences contribute to a higher death rate among women suffering a heart attack.

The French study(1) investigated more than 3,000 patients, 32% women, who had been treated for heart attacks over a two-year period.

Lead author Dr. Francois Schiele, Cardiology Chief at the University Hospital in Besancon, France, presented the results of the research at the American College of Cardiology’s 59th Annual Scientific Session in Atlanta last month. Dr. Schiele’s team found that, on average, the women studied:

Finally! The truth about what causes women’s heart attacks!

food diet apple

by Carolyn Thomas     @HeartSisters

Finally, scientists have definitive numbers proving the clear link between our diet and heart attacks.  It’s a relief to know the truth after all those conflicting nutritional studies.

1. Japanese eat very little fat and suffer fewer heart attacks than North Americans do.

2. Mexicans eat a lot of fat and suffer fewer heart attacks than their North American counterparts.

3. Chinese drink very little red wine and suffer fewer heart attacks than North Americans.

4. Italians drink a lot of red wine and suffer fewer heart attacks than North Americans.

5. Germans drink a lot of beer and eat lots of sausages and fats, and suffer fewer heart attacks than North Americans.

CONCLUSION:

Eat and drink what you like. Speaking English is apparently what kills you.

I laughed out loud when I first heard this, but it also, sadly, reinforces for me the dilemma of interpreting all cardiac research. Continue reading “Finally! The truth about what causes women’s heart attacks!”

Cardiac research: where did all the women go?

Where have all the women gone?
Toronto – Women have successfully broken the glass ceiling in the boardroom, in politics, and on the home front. Is it now time for women to lobby for equal representation in research trials?
According to the Heart and Stroke Foundation, more than 50 per cent of deaths caused by heart disease and stroke – the leading cause of death in Canada – are women.
But that’s a fact you would never guess if you looked at the gender balance in the crucial clinical trials that study cardiovascular disease, Dr. Wendy Tsang told the Canadian Cardiovascular Congress 2008 co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
Dr. Tsang reviewed landmark clinical trials between January 1, 1997 and December 31, 2007 in leading medical journals The Journal of the American Medical Association (JAMA), The Lancet ,and the New England Journal of Medicine.
“These are major trials published in the world’s leading medical journals,” says Dr. Tsang who is a cardiology resident at the University of Toronto. “Trials published in these journals undergo rigorous peer and editorial review.”
Dr. Tsang’s study found that although women comprise 53 per cent of patients in the general population with cardiovascular disease, in clinical trials they represented only 29 per cent of subjects with coronary artery disease, 25 per cent with congestive heart disease, and 34% with arrhythmias. Interestingly, they represented 61 per cent of the subjects in prevention trials.
“Our study shows the proportion of women enrolled in landmark cardiovascular clinical trials is substantially lower than you would find in the general disease population. What is even more of a shock is that this under-representation has not drastically changed over the past decade, “says Dr. Tsang.
“This study shows why it’s important to put a gender lens on research,” says Heart and Stroke Foundation spokesperson Dr. Beth Abramson. “Although women should not get the wrong message − as cardiac care and treatments are proven in female patients − optimally women should be better represented in trials.”
Dr. Abramson adds that in addition to making sure women are well represented in clinical trials, we need ongoing evaluation into possible gender differences in cardiovascular disease and how to address them.
The Heart and Stroke Foundation and CIHR’s multi-provincial GENESIS research initiative − which explores the differences in how men and women experience heart disease − is a good example of how this issue can be addressed.
“A trial may show that a drug or therapy benefits patients enrolled in the trial − but if women are under-represented in the trial, it makes it difficult to tell if the outcomes of the trial can be applied to women,” says Dr. Tsang. She says that the next step in this research is to figure out what factors affect female enrollment in clinical trials in order to help address this issue.
Addressing this issue may be more difficult than it sounds. In the United States in the early 1990s the National Institutes of Health put in place a policy that said there should be a fair representation of women in trials as long as it was reasonable.
“The results of this study are even more surprising because in 1993 in the U.S. Congress passed an act to increase enrollment of women and minorities in trials,” says Dr. Tsang.  “You would have thought that between then and 2007 there would have been a change. But we didn’t find that.”
The under-representation of women in clinical trials could be because they are asked to participate less often than males. Women get heart disease later in life than men and a lot of trials have an age rule that says nobody 70 or over can enroll. However, Dr. Tsang’s research does show women make up 61 per cent of trials that investigate exercise and diet.  Could this be due to gender stereotyping?
That could be next on the research agenda.
To find out more about gender differences in heart disease and stroke visit heartandstroke.ca or thehearttruth.ca.
Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CCS policy or position. The Heart and Stroke Foundation of Canada and the Canadian Cardiovascular Society make no representation or warranty as to their accuracy or reliability.
The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy.

by Carolyn Thomas    @HeartSisters

Here’s a news flash:  women are not just small men (like cardiologist Dr. Nieca Goldberg‘s book of the same title). In almost every area of our health, there are significant differences between men and women’s responses to both disease and treatment.  But because women are not yet equally represented in medical research, our health care professionals have had to assume that diseases and conditions affect both women and men in the same way.  

Medical research has focused on the bikini approach to women’s health: breasts and reproductive organs. And if diagnostic tests and treatments work for men, shouldn’t they also work for women?  Well, darling readers, here are some sobering facts from the Society for Women’s Health Research that show why this may not be the case: click here to find out