This Annual Report Card on Canadians Health is archived for historical purposes only. Note that the statistics and information are current as of the original release date.

Time to bridge the gender gap, says the Heart and Stroke Foundation

When it comes to heart disease and stroke, Canadian womens progress has not kept pace with mens, according to the 2007 Heart and Stroke Foundation Annual Report on Canadians Health. Research shows that, compared to a man, a womans risk of dying following a cardiovascular event such as a heart attack or stroke is higher, women are less likely to be treated by a specialist, are less likely to be transferred to another facility for treatment, and less likely to undergo cardiac catheterization or revascularization.

Its a real concern that womens heart health has not kept pace with mens, says Dr. Beth Abramson, cardiologist and spokesperson for the Heart and Stroke Foundation. There has been some progress in closing the gender gap, but when it comes to Canadas leading cause of death, there are women who may be under-served on the front lines compared to men.

For years, it was assumed that care differences occurred because women tended to be older and sicker at the point they were hospitalized. But recent analysis shows that even when you control for age and other health conditions, a womens risk of dying within the first 30 days is 16% higher for heart attack, and 11% higher for stroke, than a mans^[1]. The reasons for this are unclear - contributing factors may be systemic, social, and biological but answers need to be found.

Further, the Heart and Stroke Foundation reveals that for the first time in 30 years, women have caught up to men when it comes to the number of deaths from cardiovascular disease.

Number of Deaths From Heart Disease and Stroke: Women vs. Men, 1973 to 2003

Number of deaths from cardiovascular disease, Statistics Canada

In 1973, there were 23% fewer female than male deaths from heart disease and stroke (34,924 female deaths vs. 45,404 male deaths). By 2003, the number of male deaths had fallen (by 19%, to 37,004), while the number of female deaths increased (by 5% to 36,823). For the first time, the number of deaths from heart disease and stroke combined is virtually the same between women and men (36,823 vs. 37,004).

Canadians have this cozy misperception that having a heart attack or stroke is no longer a big deal that you can be hospitalized, treated, and return home good as new, says Dr. Abramson. But the reality for a lot of people particularly for women is very different.

Almost 37,000 Canadian women will die of heart disease and stroke this year, and women have a higher risk of dying after a heart attack or stroke. We need to better understand why, and this inequity needs to be addressed. This is a serious health issue for Canadian women.

Other findings include:

• In 1973, there were twice as many male than female deaths from heart attacks (20,680 vs. 10,539). Although men continue to lead in heart attack deaths, by 2003, the gap had closed: male deaths dropped by 49% to 10,643 but female deaths had dropped only 24% to 8,019.
  
  
• Not enough Canadians are referred to a cardiologist following a heart attack and women fare more poorly than men. Only 32% of women see a cardiologist after a heart attack, compared with 38% of men. Seeing a specialist is important when you account for age and other conditions, the risk of dying is 47% lower for patients treated by a cardiologist^[2].
  
  
• In 1973, there were 10% more female than male deaths from stroke (8,523 female deaths vs. 7,702 male deaths). By 2003, the number of female deaths from stroke had climbed to 8,951 while the number of male deaths dropped (to 6,332). As a result, in 2003 there were 41% more female than male deaths from stroke.
  
  
• Studies have shown that at all ages, women have a higher in-hospital mortality rates following heart attack than men (see Table 1).
  
  
• Women also have lower rates of undergoing coronary artery bypass surgery and angioplasty (a non-surgical procedure to reopen blocked coronary arteries; see Table 2).

Table 1
In-hospital heart attack mortality rate per 100 heart attack patients by gender, 1997/98 to 1999/2000

Source: Canadian Cardiovascular Outcomes Research Team

Table 2
Bypass surgery and percutaneous interventions per 100,000 population aged 20+ by gender, 1997/98 to 2000/01

Source: Canadian Cardiovascular Outcomes Research Team

We also need to look at access to care through a gender lens, says Dr. Abramson. Why are women less likely than men to be treated by a cardiac specialist? And why are they less likely than men to have bypass surgery or an angioplasty? This is an important piece of the puzzle.

ILLUMINATING THE GENDER GAP

A national survey of Canadians aged 35 and over conducted by the Heart and Stroke Foundation found two realities when it comes to knowledge of heart health and cardiac care. Women were acutely aware of the problems faced by female heart patients and a womans increased risk of dying. But many men have not seen the light when it comes to the heart health of their partners, mothers, siblings, or loved ones.

Men still see heart disease as a mans disease. Over half (53%) of men erroneously thought the number of heart and stroke deaths was somewhat or a lot less in women compared to men (an error made by only 27% of the women polled). Of those without a history of heart disease or stroke, 42% of the men believed it was somewhat or very likely they would develop it at some point in their lives but only 24% thought their partner or spouse would. Women, on the other hand, were more realistic about their chances: 45% thought it was likely they would develop heart disease or stroke and 43% that their partner would.

Heart and Stroke Foundation Poll of Canadians Aged 35 and Over

Results are from a nationally representative sample of 1,200 (margin of error +3.1%, 19 times out of 20); * difference between men and women is statistically significant p<.001 ** difference between men and women is statistically significant p<.01</i/>

Women and men need to realize that heart disease and stroke are equal opportunity killers, says Dr. Abramson. We need a proactive approach to womens heart health in Canada. The gender gap can and must be closed.

TIME TO ACT IS NOW, SAYS HEART AND STROKE FOUNDATION

The Heart and Stroke Foundation works on the issue of women and heart disease on a number of fronts, says Sally Brown, CEO of the Heart and Stroke Foundation of Canada. Along with specific, targeted research and health information, the Foundation is a leader in the development of the Canadian Heart Health Strategy and Action Plan, which will improve the heart health of all Canadians, but also specifically look at how to address gender and other inequities.

In 2000, the Heart and Stroke Foundation of Canada led the development of the Victoria Declaration on Women, Heart Diseases and Stroke international recommendations on how to ensure equity in heart health status between women and men. Many of the key recommendations from Victoria have not been implemented and are still relevant in 2007, including

To governments:

• Conduct ongoing population surveillance of women's health outcomes, and monitor and evaluate health services and community supports. (In fact, Canada lacks appropriate data and health information for the population as a whole and this must be improved.)
• Address the key underlying socio-economic determinants of women's heart diseases and stroke literacy and education, poverty, geography, women's roles and control over their lives, media, and equality of access to services.

To research funding bodies and universities:

• Expand research capacity to address the issue of heart disease and stroke among women.

To the health care system:

• Provide primary prevention, screening, diagnosis and treatment, prevention of recurrence, rehabilitation and support programs, and services that are tailored to women's needs.

To Canadian women and men:

• Be aware of their risk for heart disease and stroke and the signs and symptoms of cardiovascular disease. Canadians should know their personal risk factors, and speak to their physician about their target numbers with respect to blood pressure, lipid levels, and glucose levels.
• Play a proactive role in managing their own health, including eating a balanced, healthy diet that is lower in saturated and trans fats and that consists of at least five servings of fruit and vegetables per day, and aim to be physically active for 30 minutes or more on most days of the week. See our Healthy Living section for more heart-healthy information.

HOW IS THE HEART AND STROKE FOUNDATION ADDRESSING THIS ISSUE?

• Were playing a leadership role in the development of the Canadian Heart Health Strategy and Action Plan, which will improve heart health for all Canadians, while specifically looking at how to address gender and other inequities.
  
  
• We're developing a national information and awareness program to educate women about their risk of heart disease and the steps they can take to prevent them. The Heart Truth, which will be launched in 2007, is based on a very successful U.S. program that includes the well-known Red Dress media campaign.
  
  
• Were funding gender-specific research across the country to better understand the differences in how men and women experience heart disease. The GENESIS project, with over 30 investigators across Canada led by Dr. Louise Pilote at McGill University, and co-funded by the Canadian Institutes of Health Researchs Institutes of Gender and Health and Circulatory and Respiratory Health, is an excellent example that is already publishing important information.
  
  
• We provide heart health information to thousands of Canadians every year, including information specific to women and heart disease through our He@lthline e-newsletter and other publications.
  
  
• The Foundations Health Check food information program, with over 1,000 products, is targeted primarily at women, the primary food shoppers in most families, to help them easily make healthy food choices for themselves and their families (see www.healthcheck.org).

Heart and Stroke Foundation information on womens heart health and healthy living can be found at heartandstroke.ca or by calling 1-888-HSF-INFO (1-888-473-4636).

The Heart and Stroke Foundation, 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.

NOTE: This press release constitutes the Heart and Stroke Foundations Annual Report on Canadians Health there is no separate report document.

Journalists may join the Toronto press conference by dialing 1-800-595-8550 and asking for the Heart and Stroke Foundation Press Conference.

B-roll will be available through CNW Group at the listed times and co-ordinates:

Live Satellite Coordinates:

DATE OF FEED: Wednesday, January 31, 2007
TIME OF FEED: 11:00 AM ET 11:30 AM ET
CO-ORDINATES: Anik F2 C Band Analog, Transponder 3B, Audio subcarrier 6.2 and 6.8, Downlink Frequency 3820 vertical
TOC: CFA TX 1

PATHFIRE Digital Media Gateway Coordinates:

DATE OF FEED: Wednesday, January 31,2007
AVAILABLE AT: 11:00 AM ET for two weeks
CO-ORDINATES: Video Provider A, Digital Media Gateway, CNW Tab
STORY NUMBER: CNW07HSF1

For more information:

Sharon Edwards
416-489-7111, ext 482 or 416-937-5307 (cell)
sedwards@hsf.on.ca

Elissa Freeman
416-565-5605 (cell)
efreeman@hsf.on.ca

Jane-Diane Fraser
613-569-4361, ext 273
jfraser@hsf.ca

For provincial media contacts: see contact us at www.heartandstroke.ca

Date of last update: March 1, 2007

^[1] Health Care in Canada 2006. Canadian Institute for Health Information, 2006

^[2] Ibid

^[3] Number of deaths, Statistics Canada