A study published in the Journal of the American Heart Association in February, 2020, reveals a “stunning” gap in research on women’s heart and brain health, says co-author Dr. Cindy Yip, Heart & Stroke’s Director of Data, Knowledge Management and Heart Program. We asked her what the study found and why it matters.
What was the goal of this study?
Our goal was to bring forward the Canadian perspective, from coast to coast. Working with the Canadian Women’s Heart Health Alliance, powered by the Canadian Women’s Heart Health Centre at the University of Ottawa, we set out to consult the leading experts who are actively researching or caring for women with heart disease and stroke in Canada, to share what they know about the literature on this topic.
The approach was extremely inclusive. Our experts include clinicians, researchers, nurses and allied health teams at varied career stages, as well as women with lived experience of heart disease and stroke.
Why is a Canadian perspective important?
I think there are a lot of differences in terms of the population in Canada such as age, culture, and ethnicity. Our healthcare system is different and our population is very different from those of the United States and Europe.
We need to work together to support more research in order to drive changes.
For example, immigrants and newcomers have different rates of developing heart disease. Canada’s Indigenous populations are more susceptible to certain heart diseases. Diet and lifestyle choices are different in Canada as well!
So having evidence tailored for the population in Canada, specifically women, is going to best serve us.
What were some of the findings?
We knew there was a research gap, despite progress in recent years. What we learned is that the gap is bigger than we thought and it's more stunning.
The lack of research — resulting in a lack of data and evidence — really has hindered the development of clinical guidelines and best practices tailored for women.
When we did a comparison vs the U.S. and Europe, we found Canada lags far behind in terms of guidelines that provide women-specific recommendations for disease management. That was shocking.
Heart & Stroke reported on the research gap affecting women’s heart and brain health in the 2018 report called Ms. Understood. How is this different?
This paper complements Ms. Understood and validates the “unders” that we identified there, when we showed how women are under-aware, under-diagnosed and under-treated, under-researched and under supported when it comes to heart disease and stroke.
This study extends the story beyond just heart attack, covering a comprehensive range of conditions including heart failure, heart valve disease, congenital heart disease and more.
And it’s important to note that this is a peer-reviewed publication in an internationally recognized journal. So we’re increasing awareness of this important issue in Canada and beyond.
What do you hope will result from this work?
The number one thing is awareness. Then we need to all come together to close the research gap.
The recommendations at the end of the document include a role for everyone — from clinicians to researchers to women with lived experience, to health system leaders and non-profits like Heart & Stroke.
We need to work together to support more research in order to drive changes and tailor clinical practice to women.
When might we see new clinical guidelines specific to women?
That is definitely a hope, but it will be long road — more than five years away.
What was Heart & Stroke’s role in this study?
It's a new capacity that we have invested in building in the last year, that we're offering as an in-kind contribution to our collaborators. In this paper, Heart & Stroke provided resources on data analysis, writing and scientific content review.
It's also a great example of a shared leadership model (with the Canadian Women’s Heart Health Alliance). The scope of work like this is large; it’s not something that one organization can do.
We hope people in Canada will join us to advance this cause, and we look forward to more such collaborations.
You mentioned that women with lived experience were part of the team. What role did they play?
They were part of the working group from day one. And as we progressed, they provided input throughout the development of this publication. They are listed as authors alongside the professionals.