heart health · 2019. 3. 22. · barbra streisand when i made my mov-ie yentl — in which a young...

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Publisher: Courtney McNeely Business Developer: Tasha Eisen Strategic Accounts Director: Jesse Adamson Country Manager: Jacob Weingarten Content Production Manager: Ellen Asiedu Web Editor: Kaleigh McLelland Lead Designer: Mike Shea Designer: Theo Lamar Contributors: Frank Campagna,

MLPcom, Sandra MacGregor, Mediaplanet, John A. Sawdon Cover Photo: Russell James Photo credits: Tim Fraser, Tricia Hanna, Emily Janssens Send all inquiries to [email protected]. This section was created by Mediaplanet and did not involve Chatelaine or its editorial departments.

Heart disease and stroke are the leading causes of premature death for women in Canada, killing five times as many

women as breast cancer. Legendary director, singer, actress, and producer Barbra Strei-sand is on a mission to change that. She co-founded the Women’s Heart Alliance to prevent women from needlessly facing and dying from heart disease and stroke. Noel Bairey Merz, M.D., is the organization’s Scien-tific Advisor and spoke with Streisand about her deep commitment to this cause.

Noel Bairey Merz How did you become interested in advocating for those with heart disease?Barbra Streisand When I made my mov-ie Yentl — in which a young woman gets an education by pretending to be a man — I had

no idea the project would, in a roundabout way, lead me to advocate for women’s heart health. But years later, I read about “Yentl syndrome,” a phrase coined to describe the finding that women with heart attacks get substandard care compared to men. That in-equity persists to this day.

NBM Why don’t more women know about their risk?BS In a Women’s Heart Alliance survey, we found that a lot of women are embarrassed about having heart disease, others aren’t aware that they have it, and many people think heart disease strikes only old men. Too often, heart disease deaths are wrongly attributed to natu-ral causes or ailments and as a result, women are not making a personal connection to heart disease or sharing their stories.

NBM In addition to promoting awareness of women’s risk for heart disease, you’ve done a lot to advocate for health care equity for women. Why is that?BS We are decades behind in our knowl-edge about what works for women with heart disease compared to men because clinical trials have traditionally included more men than women. I remember learn-ing how different heart attacks in men and women can seem, and how frequent-ly women are misdiagnosed as a result. To ensure that trials consider the differences between the sexes, I encourage women to participate. And I plan to keep urging and advocating until we make real progress in securing the education, research, and fund-ing needed to properly diagnose and treat women’s heart disease.

Barbra Streisand Fights for Equal Billing for Women’s Health

Heart Health

One treatment does not fit all.Imagine two patients the same age, same sex and both with heart disease. Should they be given the same treatment? Not necessarily. The Peter Munk Cardiac Centre is using the power of artificial intelligence to provide personalized care for heart disease. It’s just one way we’re shaping the future of cardiac care.

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so differently to treatment?

Today’s medical landscapeThe current standard in medi-cine is a “one treatment fits all” approach. “Right now, treatment plans include guidelines on how to manage the average patient. The plans are infrequently stratified into groups, let alone tailored to individuals,” explains Dr. Heather Ross, Division Head of Cardiology at the Peter Munk Cardiac Centre, Director of the Ted Rogers Centre for Heart Research, and Loretta A. Rogers Chair in Heart Function. “This can be problematic for heart disease patients, particularly women,” Dr. Ross continues, “since the guidelines are based on clinical trials where women are underrepresented.”

When prescribing a treat-ment plan for heart disease, there is a wealth of data,

Why Some Women Respondto Treatment, but Others Don’t

Imagine this scenario.Two women, both 45-years-

old and leading a similar lifestyle, arrive at the hospital severely fatigued and exhibiting shortness of breath. They are both found to have heart failure; a condition where your heart is not effectively pumping blood throughout your body.

A diagnosis of heart failure is severe for anyone, but treatment is designed to manage the symp-toms. In this case, one woman responds well to the treatment and is able to be discharged from the hospital the next day, while the other woman continues to experience shortness of breath and has to be transferred to the intensive care unit. Despite a heightened level of care, the woman’s kidneys begin to fail. Soon, other organs follow suit. She dies within a matter of days.

Why did the women respond

Heart disease is different for everybody. The Peter Munk Cardiac Centre is using artificial intelligence to figure out why.

The Peter Munk Cardiac Centre is using artificial intelligence to provide personalized cardiac care. Support this at

inaheartbeat.ca.

Dr. Heather Ross at the Peter Munk Cardiac Centre, where

they are at the forefront of integrating artificial

intelligence in medicine.Photo: Tim Fraser

imaging, laboratory testing, and medical history that should be taken into account to have a better chance of success. The problem is the sheer volume of data and time-sensitive nature of treatment which make it impossible to interpret the data in a meaningful way. Without assistance, the amount of data available now exceeds the cap-acity of the human mind. That’s where artificial intelligence comes in.

Tomorrow’s medical futureThe team at the Peter Munk Cardiac Centre is learning more about the intersection of arti-ficial intelligence and cardiac care. Artificial intelligence takes a tremendous amount of patient data and uncovers patterns the human brain cannot see.

“We currently ignore some

data because it’s so complex,” notes Dr. Cedric Manlhiot, Director of the Cardiovascular Data Management Centre at the Ted Rogers Centre for Heart Research. “For example, right now, after an exercise test, clinicians focus on a handful of data points out of the thou-sands that are generated by the test. We have created an artifi-cial intelligence algorithm that interprets the data that has trad-itionally been left out. For the first time, clinicians are now provided with unique insights allowing them to select the most appropriate therapy for each individual patient,” he explains.

The future of artificial intelli-gence does not stop at developing a more responsive treatment plan, however. “By making sense of the personalized data that is available, we will be able to offer patients the right treatment at the right time, before heart dis-ease occurs,” says Dr. Carolina Alba, a Cardiologist and Scien-tist at the Peter Munk Cardiac Centre. By developing special-ized algorithms, cardiologists can move towards preventative monitoring as opposed to react-ive treatment.

Thanks to advancements in artificial intelligence, a new scenario is possible. In it, two women visit their doctor’s office for a routine check-up and their physicians calmly explain that based on their age, sex, ethnic background, genetic compos-ition, tests, and medical history, they are both at risk of heart disease. Undeterred, the phys-ician proceeds to develop a personalized treatment plan for each woman that successfully prevents the disease from devel-oping in their lifetime.

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In the 1970s, Dr. David Mymin had an unorthodox idea. At the time, the standard for patients

recovering from cardiac events or surgery was bed rest. But Dr. Mymin, working at St. Boni-face Hospital in Winnipeg, MB, was confident that exercise, not inactivity, was the key to a strong recovery and a healthier future.

His unique approach blos-somed into a comprehensive medical fitness program now housed in a state-of-the-art med-ical fitness facility christened the Reh-Fit Centre. It will celebrate its 40th anniversary this year. The Centre is Canada’s premier cardiac rehabilitation and “prehabilita-tion” institution and is improving

the health and quality of life of the community while literally saving lives. It’s a community hub where those with cardiac disease or other chronic conditions, as well as community members at large, can become physically fit in a welcoming environment with guidance from health and well-ness professionals.

Recognized globallyReh-Fit is Canada’s first med-ical fitness facility as certified by the Medical Fitness Association, bringing pride to the province by meeting the highest global stan-dards for fitness and wellness. But Sue Boreskie, Reh-Fit’s CEO, is not resting on her laurels. “It is a feather in our cap in terms of recognition,” she acknowledges, “but we’re always looking for ways to expand Reh-Fit’s role in the community and continue to be innovative.”

Frank Campagna

A Unique, Fitness-Focused Approach to Heart Health

1Understand the importance of activityPhysical activity includes

any body movement that works your muscles and requires more energy than resting. When we do regular, moderate, and vigorous physical activity, it strengthens the heart muscle. This improves its ability to pump blood through-out your body, meaning more blood flows to your muscles, and oxygen levels in your blood rise. Capillaries, which are the body’s tiny blood vessels, also widen. This allows them to deliver more oxygen to your body, strength-ening cells and removing waste.

4 Find a friendImplementing regu-lar physical activity

becomes much easier if you get active with a friend. This kind of social support helps to reinforce your motivation while building your energy and enthusiasm.

John A. Sawdon, Public Education & Special Projects Director, Cardiac Health Foundation of Canada

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Exercising regularly is a key strategy in preventing heart disease. It’s an easy lifestyle habit to adopt that helps to reduce high blood pressure and improve poor

cholesterol levels. If these factors aren’t under control, they can lead to significant health issues including heart disease, obesity, heart attacks, and/or strokes.

Unfortunately, only 20 percent of Canadian adults and 10 percent of Canadian children and youth meet the standards outlined in the Canadian Physical Activity Guidelines. Beginning to exercise may seem like a daunting task, but it can be easy to get started with these four simple steps.

Exercise: The Key to Heart Health at Any Age

2 Know the basicsThere are four types of physical activity: aer-

obic, muscle strengthening, bone-strengthening, and stretch-ing. Aerobic exercise is the best method to strengthen your heart as it makes your heart beat faster than usual, which in turn makes you breathe harder. Over time, aerobic activities such as walk-ing, running, cycling, dancing, and swimming make your heart and lungs stronger.

If you have a chronic condi-tion, like heart disease, ask your doctor to provide some guidelines on the safest, most effective forms of exercise for your condition.

3 Start smallThe Canadian Physical Activity Guidelines rec-

ommend at least two and a half hours of moderate to vig-orous physical activity per week. While this number may seem like a lot at first, it can be accumulated in short inter-vals like a 10-minute walk after each meal. If you have not been active for a while, start at a pace that’s comfortable and gradually increase the intensity and dur-ation of exercise as your body adapts.

Photo: Emily Janssens

Photo: Cecilie_Arcurs/Getty Images


Dr. Shelley ZierothCardiologist,

St. Boniface Hospital

T he saying “what you don’t know can’t hurt you” should never apply

when talking about your health. For people with type 2 diabetes, learning about heart disease risks can be lifesaving.

When we think about heart attacks, we tend to imagine a man falling to the floor holding his hand to his chest. Generally, women are not as concerned about their hearts, and often mistakenly believe they are more likely to die from a disease like cancer. Yet the reality is that heart disease and stroke are the leading causes of premature death among Canadian women.

Understand the risksThe term heart disease generally describes a heart that does not function properly. Specifically, it describes instances of heart fail-ure or stroke due to a blockage developing in the arteries. The most well-known risk factors are smoking and high cholesterol levels, but other factors — includ-ing living with diabetes — play a determining role.

Nevertheless, research shows that 93 percent of Canadians who have type 2 diabetes believe they know how to manage their illness, when in reality one out of two are unaware that their diabetes increases the risk of heart disease or stroke. “The

link between type 2 diabetes and heart disease is very strong,” explains Dr. Shelley Zieroth, a cardiologist at St. Boniface Hospi-tal in Manitoba. According to her, 80 percent of Canadians with diabetes will die of coronary dis-ease — an astounding number.

A lack of knowledge about the symptoms associated with heart disease can increase the risk of mortality. The most obvious warning sign is pressure or tight-ness in the chest during physical exertion, but other warning signs include feeling short of breath and experiencing fatigue, nausea, or dizziness, as well as jaw or back pain. Symptoms tend to be more subtle for women, who may feel chest discomfort rather than crushing pain.

Start a conversationAs a cardiologist, Dr. Zieroth is enthusiastic about being involved with her patients who are managing their diabetes. In addition to knowing the risks of heart disease, people with dia-betes can take steps to prevent it. Dr. Zieroth says patients with diabetes should closely monitor their blood sugar, blood pressure, and cholesterol levels. Adopting healthy lifestyle habits, such as quitting smoking, exercising regularly, and eating smaller portions, is just as crucial. “But above all, we want patients to

speak with their doctor because the good news is that there are new treatments that can prevent premature death for people with diabetes,” she says.

Clinical trials have shown that these new treatments not only prevent deaths related to heart disease but also prevent the onset of heart failure. A dis-cussion with one’s medical team is the best way for people living with diabetes to make sure they have all the information required to keep living a healthy life.

The Risky Link Between Diabetes and Heart Disease

SOURCES: Environics Research Group, World Health Organization, Diabetes Canada

93 of Canadians with diabetes feel they are

knowledgeable about their disease management, but one in two have no idea their diabetes significantly increases the risk of heart attack, heart failure and stroke.

56 of Canadians don’t know or don’t

believe heart disease is the most common cause of death among adults with type 2 diabetes.

41 of Canadians with type 2 diabetes

believe there are no medications that control blood sugar levels and heart disease.

Brenda Hanna (pictured) is now able to spend more time doing the things she loves, like playing with her rottweiler Freddie.Photo: Tricia Hanna

If you are living with type 2 diabetes, talk to your doctor about ways to minimize your risk of developing heart disease. To find out more, visit myheartmatters.ca.

Approximately 1 in 2 Canadians with type 2 diabetes will die of heart disease. Even one death is too many.

Visit myheartmatters.ca to learn more


radically changed her life. “Stairs are no longer a problem for me, and now I can breathe much more easily and deeply,” she explains.

Now that she is retired, she is finally taking time to better educate herself about her dia-

betes. Hanna recommends this approach to everyone. “Read, read, read,” she says. “Become your own diabetes expert. Ask your doctor about the link between diabetes and heart disease, and how they can progress if left unmanaged. It’s a sneaky disease that you should take seriously.”

Sawdon also believes in the importance of patients and their doctor acting as a team, and of going beyond guilt and judgment. “People can’t manage this by themselves,” he says. “We have to accept them as they are and work with them to find solutions.”

By following a healthy diet, getting regular exercise, and fol-lowing an appropriate treatment plan, people with type 2 diabetes can improve their life expectancy and manage their risk of heart dis-ease. With Hanna’s heart disease and diabetes now under control, she continues to do the things she loves like gardening and playing with her rottweiler.

Original articles by MLPcomTranslated from French by MLPcom

When Brenda Hanna was told she had type 2 dia-betes, she followed her

doctor’s orders, took the prescribed medication, and paid greater atten-tion to her diet and blood sugar levels. But what the 51-year-old television producer didn’t real-ize was that diabetes could have effects on other areas of her health. “I was widowed, raising an eight-year-old daughter by myself, and had tenants and a demanding job. Researching further into my diabetes was very low on my list of priorities,” Hanna explains, regarding her lack of concern.

Making the connectionSeven years after being diagnosed

with diabetes, Hanna started having trouble breathing. It wasn’t until she had to call 911— because her symptoms were so advanced, that she learned she was suffering from heart fail-ure. Despite this new diagnosis,

at the time Hanna was still unaware that her heart problems were linked to her diabetes.

This lack of awareness of the connection between type 2 dia-betes and heart disease is common among patients with diabetes according to John Sawdon, Public Education and Special Projects Director for the Cardiac Health Foundation of Canada, an organ-ization dedicated to educating the public about heart disease.

The risk, however, is real. Alarmingly, women with dia-betes have a 150 percent higher risk of heart attack than women who don’t have diabetes. Further-more, type 2 diabetes can reduce one’s life expectancy by 15 years, precisely because of heart dis-ease. These were critical facts that Hanna was unaware of at the time of her diagnosis.

New treatment, renewed lifeA year ago, Hanna’s cardiologist recommended a new treatment for her type 2 diabetes that also had proactive benefits for the heart. That therapeutic approach has

“

“I was widowed, raising an 8-year-old daughter by myself, and had tenants and a demanding

job. Researching my diabetes was very low on my list of priorities.

People with type 2 diabetes are often unaware that their disease can have a direct impact on their heart health. One woman shares her story of diabetes-related heart failure and explains how others can educate and protect themselves.

Treatment Advances Can Help People with Type 2 Diabetes

John A. Sawdon Public Education & Special Projects Director, Cardiac

Health Foundation of Canada

These articles were brought to you by two of Canada s leading research-based pharmaceutical companies.

Approximately 1 in 2 Canadians with type 2 diabetes will die of heart disease. Even one death is too many.

Visit myheartmatters.ca to learn more


At some point, we all consider just how capably we could handle an emergency. Though we generally think of ourselves as calm, confident individuals, the truth is that in a stressful, life-threatening situation it can be difficult to know how to properly respond.

Many Canadians lack proper trainingThough we may have different confi-dence levels when it comes to handling emergencies, we can agree there are few things worse than feeling helpless in assisting a loved one in distress. How-ever, according to a 2016 Ipsos survey conducted on behalf of the Canadian Red Cross, one-third of Canadian households lack someone trained in first aid. More remarkable is that despite this noted lack of knowledge, three quarters of Can-adians believe they would know how to respond if they saw someone fall off a

ladder or otherwise injure themselves. Without training, how many of us

can tell the difference between the signs of a stroke or an anxiety attack? How many of us know that nausea, vomit-ing, and jaw pain can be signs of a heart attack?

A course that could save a lifeThe Red Cross offers an array of first aid courses created to make it easier for people to learn how to prevent and respond to heart attacks and other med-ical emergencies. The organization wants Canadians to feel confident they can successfully come to the aid of family, friends, and community members in an emergency.

Red Cross’ teaching philosophy has evolved to become more learner-cen-tric. The organization offers a blended approach to studying that allows par-ticipants to learn concepts online and

progress through the course stages using self-guided study. Once participants feel confident with what they have learned, they can continue the course with an instructor in a classroom setting.

“Canadian Red Cross programs are built in a way that focuses on an individ-ual’s confidence to act in an emergency,” explains Don Marentette, the Director of First Aid Programs for the Canadian Red Cross. “As an organization, we place less importance on people remembering exact steps, and more on recognizing the need for help. We feel it’s important to empower individuals to be confident in their abilities to offer help and potentially save a life.”

It’s impressive that in a few short hours you can learn critical skills that could make the difference between life and death for a loved one.

Sandra MacGregor

Empower YourselfTo Help Those You Love In An Emergency


Women and Heart Disease:A Resource Guide T raditionally considered a disease

primarily affecting men, heart disease is a silent killer of women

around the world. In fact, according to the Heart & Stroke Foundation, five times as many women die from cardiovascular dis-ease than breast cancer each year.

The following information provides additional resources that may be helpful in learning more about what women can do to prevent cardiovascular disease or manage the impact of the disease on their lives if recently diagnosed.

Heart Research InstituteEstablished in 1989, the Heart Research Institute is a world-class leader in cardio-vascular research. They have 12 research groups across 20 countries including Canada, New Zealand, the UK, the US, and the Netherlands. Visit hricanada.org to learn more.

Heart SistersThis site, focusing on women’s experi-ences with cardiovascular disease, is authored by Carolyn Thomas. She is also the founder of the blog Heart Sisters and author of A Woman’s Guide to Living With Heart Disease.Read more at myheartsisters.org.

The Heart and Stroke FoundationThe world-renowned organization recently published their Ms. Understood Heart & Stroke 2018 Heart Report, outlining the importance of ensuring that health care systems are equipped to diagnose, treat, and support women with cardiovascular disease.

The Foundation’s main website offers extensive information on cardiovascu-lar disease, valvular disease heart failure, and arrhythmia alongside tips for imple-menting lifestyle changes aimed at preventing cardiovascular disease.

The foundation’s Heart Truth Campaign seeks to raise awareness among women of how they can reduce their risk of heart dis-ease and stroke. Visit thehearttruth.ca for more information.

Canadian Women’s Heart Health CentreThe Canadian Women’s Heart Health Centre — in collaboration with the University of Ottawa Heart Institute — is dedicated to ensuring knowledge gaps are closed and high-quality care is made available across the patient spectrum when it comes to women’s experiences with cardiovascular disease. Among other focuses, the Centre builds programs to help improve care, increase prevention-focused activities, and increase the quality and quantity of heart research focusing on women.Learn more at cwhhc.ottawaheart.ca.

Women’s College Hospital Since 1996, Women’s College Hospital has operated the Women’s Cardiovascular Health Initiative to provide rehabilitation services for women with existing or poten-tial heart problems through small group therapy sessions, individual exercise pro-grams, and support groups. For more information, email [email protected] or call 416-323-6400 ext 4883.

HeartLife Foundation: The HeartLife Foundation is the leading voice for heart failure patients in Canada and acts as the only nationwide, patient-led organization focused on raising aware-ness, improving access to treatment, and empowering patient voices around the topic of heart failure and its effects on families and caregivers. For more information, visit heartlife.ca.

Canadian SADS FoundationThe Canadian Sudden Arrhythmia Death Syndrome (SADS) Foundation is committed to supporting families with inherited car-diac rhythm disorders. Their website offers a wide range of information for patients and caregivers.Visit sads.ca or call 1-877-525-5995 to learn more.

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heart health · 2019. 3. 22. · barbra streisand when i made my mov-ie yentl — in which a young...

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