The Roundtable participants came to Madrid from 15 countries, and included women living with heart disease, patient organization leaders, public health experts, cardiac researchers and clinicians.What grabbed my attention while reading their recently published Roundtable report were the clear priorities identified up front on these four areas of urgent need.

And if female heart patients are ever going to stop being – as this report described our current reality – “under-studied, under-recognized, under-diagnosed and under-treated”, these issues must indeed be addressed  urgently.

Importantly, this report avoids what I was whining about last week here (which was basically about cardiac studies describing only the ‘ain’t it awful?’ problems in women’s heart health care without equal weight for addressing the problem).  In this 20-page Roundtable report, I went straight to the four practical recommendations in the section called Priorities for Improving Cardiovascular Disease Screening, Diagnosis and Treatment in Women.

My own take on each of the the four key priorities are in brackets, below:

♥  #1 Priority:   Embedding women’s cardiovascular health in the medical education curriculum: (My absolute favourite recommendation: we have to reach our future doctors – and nurses- now.  Currently, few if any med students learn about women’s unique cardiovascular health issues, and, as the report pointed out, “Even when such education is offered, classes are typically optional and may not include up-to-date research findings on women’s heart disease.”  This training can no longer be optional).

And for comprehensive up-to-date research findings, see also:  Nine Lessons about Women’s Heart Disease that Future Doctors will Learn in Med School

♥  #2 Priority:   Calling for mandatory gender equity and sex-specific data analysis in cardiovascular research:  (Most cardiac research in the past has been done on white, middle-aged men, whose results are not always applicable to female patients – which explains a lot.  Even in the more recent $100 million ISCHEMIA heart study of 2019, only 23 per cent of its 5,000+ heart patients were women. And as long as high impact medical journal editors continue to accept submitted research papers like this for publication – even with such clearly lop-sided participation numbers – we’ll continue to have male-centric medical care as a result).  See also: Modern Medicine is Male-Centric Medicine, and That’s a Problem for Women featuring Dr. Alyson McGregor’s work.

♥  #3 Priority:   Launching a global awareness campaign on women’s cardiovascular health:  (Increased awareness is intuitively one of the first goals believed to change attitudes and behaviours, but the reality is that, as the American Heart Association’s last national survey unfortunately revealed, women are less informed now than they were a decade earlier – despite years of massive and expensive ‘Go Red for Women’ public awareness-raising campaigns. Most women surveyed, for example, could not name chest pain as a cardiac symptom, and most still believe that breast cancer is our biggest killer. It is not: heart disease kills more women each year than all forms of cancer combined. See what I just did there? I too reflexively feel that what people need is more information, facts and data – even when experts tell us it doesn’t work.

Think about this: if more information, more facts and more data actually did work to effectively raise awareness and change attitudes, the anti-vax movement would have changed their minds by now.

This AHA survey’s appalling results were so upsetting to me, in fact, that I even stopped writing about women’s heart health for an entire summer, wondering: “Does anything I write or speak about even matter?”  What I finally came to was:  “

This does matter to women living with heart disease!”

But I now suspect that the general public feels much like I did, pre-heart attack:

“Heart disease did NOT matter to me until it HAPPENED to me!” 

And as University of Florida researchers reported:

“Because abundant research shows that people who are simply given more information are unlikely to change their beliefs or behavior, it’s time for activists and organizations seeking to drive change in the public interest to move beyond just raising awareness.)”

See also: Women’s Heart Disease: An Awareness Campaign Fail?

♥ #4 Priority:   Prioritize cardiovascular health screening in women at primary and community care settings:  (We already know that cardiovascular disease is the number one killer of women worldwide, yet – as the report found – it is “not yet standard practice to offer even basic heart health screenings to women.” 

When I started my annual Saturday morning Cardiac Café presentations on women’s heart health at the University of Victoria, for example, we included trained “Take The Pressure Down” volunteers offering free blood pressure checks as the audience members were arriving. Over the five years we did these presentations, many of the women were shocked when told their blood pressure was too high – a known risk factor for cardiovascular disease. The Roundtable report also recommended including pharmacists and nurses for these community health screenings. I’d also add all physicians caring for any pregnant women experiencing pregnancy complications, another known cardiac risk factor unique to women.  Previous studies(1) in the U.S. have found that blood pressure screenings in barbershops, churches and other community venues in black neighbourhoods resulted in significantly greater reduction in blood pressure numbers to help promote heart disease and stroke prevention.)  See also:  Do You Know the New Heart Health Guidelines for Women?

The Madrid Roundtable report concluded with this encouraging message:

“Being driven by patients, this initiative ensured that these recommendations are patient-centred and targeted towards addressing women’s specific needs and concerns.”

It’s too early to see the ultimate outcomes of assigning ambitious priorities, but could this be the kickstart needed to amplify the voices of women and their cardiologists to finally address the appalling disparity between men’s and women’s cardiac research, diagnoses, treatment and outcomes?

You can read the Global Heart Hub Roundtable report here.

1. Schoenthaler, A. “The FAITH study (Faith-Based Approaches in the Treatment of Hypertension.” Circulation Quality and Outcomes. Volume 11, Number 10. 9 October 2018.

Heart image: GDJ at Pixabay

♥

Q:  What strikes you as the most urgent of the four priorities from this Roundtable?

.

NOTE FROM CAROLYN:   I wrote much more (about facts, data and information, and mostly about what to expect when you become a heart patient!)  in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).