It’s time to transform women’s heart and brain health

We’re making progress but there’s so much more to do

Women are dying unnecessarily because we don’t fully understand the difference between women’s and men’s hearts and brains. 

Karen Narraway was repeatedly told her chest pain and shortness of breath were likely caused by anxiety. Finally, after almost two years of increasing symptoms and inconclusive tests, an angiogram revealed that she had advanced heart disease. Karen needed immediate bypass surgery to correct six blockages in her coronary arteries.

Karen may be one of the lucky ones. More than 32,000 women in Canada die each year from heart disease. Heart disease and stroke are the #1 cause of premature death for women. 

Despite this fact, two-thirds of clinical research is based on men. Women’s hearts and brains are different, and we can’t expect doctors and other healthcare professionals to recognize all the symptoms of heart disease and stroke in women until the research does. 

What we need to learn

The research gap means we lack critical information about the impact of differences between women’s and men’s hearts and brains. For example:

  • Women’s hearts and arteries are smaller, and plaque builds in different ways. 
  • Symptoms in women are more likely to be dismissed until it’s too late.

We also need to understand why some conditions have more impact on women:

  • In 2019, 32% more women than men died of stroke in Canada. 
  • Women who have had a stroke have worse outcomes than men; they experience lower levels of mental and physical well-being. 
  • Heart attacks are more deadly for women, and women are more likely than men to suffer a second heart attack.

Finally, some risks are specific to women’s bodies and lives. For example:

  • Pregnancy, menopause and hormonal changes affect women’s risk. 
  • Gender-based differences such as lower socio-economic status also impact women’s health.

Turning anger into action

Closing this research gap requires united effort including healthcare providers, policy makers, researchers, community partners and women themselves, says Dr. Sharon Mulvagh, a cardiologist and professor at Dalhousie University and chair of the Heart & Stroke provincial board in Nova Scotia. “It's multifaceted and it's complex, but we're making progress.”

Over the past five years, Heart & Stroke has mobilized over $10.5 million of funding from government, corporate, and major gift donors to address the health inequities that women face. Our impact includes:

  • Generating new evidence to improve women’s heart and brain health: With support from donors, we funded 26 research projects, resulting in over 100 publications. Examples include research by Dr. Margie Davenport and Dr. Jacqueline Saw.
  • Introducing sex- and gender-based analysis and reporting as a requirement: We are moving toward 100% compliance with this requirement.
  • Convening a powerful network of 200 champions: The Women’s Research Network brought together researchers, clinicians, systems change leaders, and women with lived experience to share knowledge and become ambassadors for research equity, leading the change in their communities, sectors, and beyond.
What's next

“The issue of cardiovascular disease in women is one that has only recently been recognized,” says Dr. Mulvagh. “But it's been really an exciting journey for me to have seen how much and how far we have come in our work increasing awareness of heart disease in women.

“I think one of the most important things that Heart & Stroke is going to be able to focus on, with their well-established granting infrastructure, is driving support and funding for research to address the glaring unmet needs due to numerous gaps in our understanding of cardiovascular disease in women, including disease recognition, mechanisms and treatment. And that is going to have a huge impact on cardiovascular outcomes in Canadian women.”

Our focus on women's heart and brain health research will continue, thanks to Heart & Stroke donors and corporate partners including Munich Re, Canada (Life). With this support, Heart & Stroke will ensure balanced, representative and equitable studies that shed light on the differences and similarities of cardiovascular disease in all genders, so that all may benefit from appropriate diagnosis and treatment.

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