Lifestyle and heart health

You probably don’t know that 8 in 10 cases of premature heart disease and stroke cases are preventable through healthy lifestyle behaviours.

February is Heart Month. In 2023, the focus of the Heart and Stroke Foundation of Canada is women. It’s about time that women were front and centre when it comes to cardiovascular disease, say experts in women’s health. Gaps in research, diagnosis and care are threatening women’s lives, warns the foundation.

Cardiac disease contributing factors

• Stress: If you’re highly stressed, always in fight or flight mode, with the stress hormone cortisol streaming through your body at high levels that don’t recover, this can cause damage to the cardiovascular system. The emotional response of women to stress may be one of the causes of their predisposition to more complications once they develop coronary heart disease.
• Stress at home: Another risk factor for cardiovascular disease, especially for middle-aged women, was the stress at home. Research looking at all the stressful factors associated with poor heart health – housework, caregiving, number of children, income, lack of emotional support at home – found that the higher the stress score, the more likely someone was to have a second heart attack. One of the main predictors is trying to manage a household and continue to function.
• Loneliness: Among older adults, the majority of whom are women, loneliness is associated with increased risk for elevated blood pressure and atherosclerosis, and increased risk of coronary heart disease, stroke, cardiovascular mortality and premature death. In Canada, one in four older women report feeling lonely at least some of the time, a feeling that may increase during winter months.
• Social situation: Another contributing factor to older women’s vulnerability to cardiac dysfunction, not widely recognized or studied until recently, is their social situation.

Improving your heart health

Tips on how women can advocate for themselves to get the health care they need:

Make your health a priority

“It’s like the oxygen masks on an airplane,” says University of Alberta associate dean of research and nursing professor Dr. Colleen Norris. “You can’t take care of those you love if you don’t take care of yourself first.”

Develop a relationship with your primary care clinician

Seek out a clinician you trust. This could be a physician or a nurse practitioner, who may have more time and training to address all of the factors that affect your health.

“The medical model is cure; the nursing model is care,” said Norris. “Nurses are educated to address not just the physical but also the whole psychosocial picture.” It doesn’t matter so much whether you choose a male or female practitioner, Norris said. What’s really important is that they answer all of your questions.

Your clinician should be asking you lots of questions too, Norris noted. That’s because, like all of us, they have unconscious, innate biases that can get in the way of seeing you clearly.

“The minute you walk into the room, they are guessing at your age, and because you’re female, they’re thinking about what they know happens to females in your age group — so if you’re premenopausal, they’re thinking you’re more prone to anxiety and depression,” Norris said.

“They will make assumptions about what they know from a medical perspective, before they know anything about your personal history.”

Recognize stress and get help to alleviate it

A good health-care professional will help you identify stress and how it affects your health and look for ways to manage it.

Find a community of support

Norris said there’s truth to the old saying about social support: men stay healthier when they’re married; women do better when they have a friend or a daughter for support.

Be persistent if you think something is wrong

“If you think something is wrong, then something is wrong,” Norris insists, and your clinician should be responsive.

Some tips to make sure you are heard:

• Take someone with you who can help brainstorm questions with you and take notes during the appointment
• Make sure you understand all the medical jargon and ask for definitions if you don’t
• Recap as the conversation goes on so you’re sure you understand it all and know what actions will be taken next
• Follow up to be sure you’re getting test results and that prescribed treatments are working