Your Heart, Your Health: two hours in one fantastic picture

by Carolyn Thomas    @HeartSisters

What you’re looking at is called a graphic recording. It’s live visual notetaking of one presentation – drawn by Vancouver illustrator Sam Bradd. As Sam explains, this kind of on-the-spot graphic recording “helps people remember and care about ideas. It supports interaction, reflection, and seeing the next steps.”  When I spoke recently at the public panel discussion event called Your Heart, Your Health hosted by Vancouver Coastal Health Research Institute, Sam started the evening up near the stage with a blank page about 4’x8′ wide.  By the end of the evening, we had what you see here!

Afterwards, I loved being described by event organizers as aknowledge translator along with Sam for our roles both during this presentation on women’s heart health as well as in the ongoing work we do with patients. Continue reading “Your Heart, Your Health: two hours in one fantastic picture”

Downplaying symptoms: just pretend it’s NOT a heart attack

by Carolyn Thomas  @HeartSisters

When a blockage or spasm in one or more of your coronary arteries stops allowing freshly oxygenated blood to feed your heart muscle, a heart attack can happen. The faster you can access emergency treatment to address that culprit artery, the better your chances of being appropriately diagnosed.  The period of time between your first symptoms and actively getting the help you need can be divided into three phases:

  1. decision time – the period from the first onset of acute symptoms to the decision to seek care (for example, calling 911)
  2. transport time – the period from the decision to seek care to arrival at the Emergency Department
  3. therapy timethe period from arrival at the Emergency Department to the start of medical treatment

Only the first phase is the one you have complete control over. So don’t blow it.   .       . 

Continue reading “Downplaying symptoms: just pretend it’s NOT a heart attack”

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 or
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 (, 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

The ‘bikini approach’ to women’s health research

by Carolyn Thomas

We know that, until very recently, cardiac research for the past three decades has been done either exclusively on men, or with women represented in statistically insignificant numbers. Medical researchers have largely taken a ‘bikini approach’ to women’s health care – in which women’s health research focuses on breasts and the reproductive system.

In a recent WomenHeart interview, Mayo Clinic cardiologist Dr. Sharonne Hayes, founder of the Mayo Women’s Heart Clinic in Rochester, MN, explains:

“In the 1960s, erroneous assertions that heart disease was a man’s disease were widely spread to the medical community and to the public.  This led to research almost exclusively focused on cardiovascular disease in men.  Many clinical trials in the 70s and 80s excluded women or simply didn’t make an effort to enroll women in sufficient numbers to draw sex-based conclusions.” Continue reading “The ‘bikini approach’ to women’s health research”