Toronto - Physicians are short-changing Canadian women when it

comes to taking care of their hearts, says Dr. Susan K. Bennett,

delivering the Heart and Stroke Foundation of Canada Lecture at

the Canadian Cardiovascular Congress 2008.

"Doctors need to hear the message about the significant deficits

in women's heart health care and bridge this gender gap," says

Dr. Bennett, director of the women's heart program at George

Washington University Hospital.

She says that as the public's awareness and knowledge about

women's risk factors and warning signs increases thanks to

increased public awareness campaigns, more and more women are

going to their doctors with their concerns. Yet often, she says,

their healthcare providers are not up to date on how women can

experience heart disease differently than men. "Healthcare

professionals need to be educated about women's cardiovascular

issues and meet the public's expectations," says Dr. Bennett.

"There is a serious gap in awareness in medical professions,"

she says. "Data suggests that women do not receive the same care

that men do. We need to explore the reasons why and close that

gap.

"Meetings such as the Canadian Cardiovascular Congress are

opportunities to work towards closing this gender gap and meeting

women's needs for more effective care delivery."

Heart disease and stroke are the leading cause of death in Canada

and responsible for the death of one in three women. Bennett

notes that when it comes to prevention and treatment of heart

disease, there are some worrisome disparities with respect to

women's heart health on both sides of the border.

The 2007 Heart and Stroke Foundation report card revealed that

Canadian women's heart health has not kept pace with men's. The

reasons for this are still unclear. The report concluded that

contributing factors may be systemic, social, and biological -

and answers need to be found.

Why the gap?

Bennett says physicians are either not entirely comfortable with

the issue of gender differences or are not ready to meet women's

needs. "There's a huge population within the medical care

community - obstetricians, gynaecologists, emergency room

physicians, family doctors - who still haven't gotten the

message."

Bennett points to a 2005 American Heart Association poll which

found a striking lack of knowledge in the medical community.

Only eight per cent of primary care physicians and 17 per cent of

cardiologists correctly knew that more American women than men

die of heart disease.

She says there is a similar lack of knowledge among Canadian

healthcare professionals and points to the fact that fewer women

are referred to a cardiologist following a heart attack, they

have lower rates of undergoing coronary artery bypass surgery and

angioplasty, and they are less likely to be transferred to

another facility for treatment.

Bridging the gap

Bennett calls on healthcare professionals to break down the walls

and become a bridge for women's heart health.

For this to happen, she says more efforts need to be made to get

the message about women's heart health needs to the medical care

community.

In her opinion, physicians frequently underestimate a women's

risk for heart disease. "Their perception of women being at low

risk for heart disease leads to inaction," says Bennett. "We need

more emphasis on women's uncontrolled hypertension, high

cholesterol levels, and lifestyle risks."

She says that dealing with prevention issues is key. "But doctors

are busy and often don't have the time to discuss prevention,"

she says.

It doesn't help, either, that clinical trials still under-

represent women to a considerable degree. When results are in and

a new drug or device is declared advantageous, results may not

apply to women because women made up such a minority of the

clinical trial population that no solid conclusions can be drawn.

"Not all drugs work the same in men and women but we don't know

enough about these differences to exploit their advantages or

disadvantages," Dr. Bennett said.

Dr. Bennett notes that decision-making seems to be slower when

women present to the emergency department with heart attack

symptoms and they receive the necessary tests somewhat later than

men. "Once they get to the cardiac cath lab, they get reasonably

good care," Dr. Bennett observed, "but mortality rates among

women are still higher than they are for men."

That was the impetus behind the launch of the Heart Truth

campaign in the U.S., the campaign to get women to talk to their

doctors about their risk for heart disease. The Heart and Stroke

Foundation of Canada adapted the campaign and launched it in

Canada in 2008. Bennett cites that public awareness in the U.S.

has consistently gone up since the program was introduced but

while the majority of women claim to know it's the number one

killer, they think, "it's not my number one killer."

"As professionals, we need to be reminded that there is a

significant deficit in heart healthcare for women," says Dr.

Lyall Higginson, president of the Canadian Cardiovascular

Society.  "We need to work diligently to improve. This annual

meeting is important to educate professionals on issues like this

and it is why The Heart Truth campaign is vitally important to

improve cardiovascular health for Canadian women."

"The Heart Truth has done an amazing job of educating women and

encouraging women to seek cardiovascular care," says Bennett, who

is a spokesperson for The Heart Truth in the U.S. "Now healthcare

professionals need to get the message. As awareness among women

does increase, female patients are going to expect a better level

of care.

"Physicians make unconscious choices sometimes, whether talking

to a male or female patient and just the interaction itself

determines how you end up treating your patient - gender is a big

part of it and it's not going away."

The Canadian Cardiovascular Congress is co-hosted by the Heart

and Stroke Foundation and the Canadian Cardiovascular Society.

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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 (heartandstroke.ca), 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.

The Canadian Cardiovascular Society (ccs.ca) is the national

voice for cardiovascular physicians and scientists. Its mission

is to promote cardiovascular health and care through knowledge

translation, professional development, and leadership in health

policy.

To find out more about The Heart Truth and women and heart

disease, visit thehearttruth.ca.

For more information and/or interviews, contact the

CCC 2008 MEDIA OFFICE AT 416-585-3703 (Oct 26-29)