First of its kind clinic graduates healthy hearts

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When Iva Fisher first joined the BC Metabolic Syndrome Program at St. Paul’s Hospital in Vancouver she wasn’t sure what to expect from the 18-month program. She had already lost 40 pounds but her weight loss had plateaued. Despite her progress, Iva’s doctor was still concerned about her risk of a heart attack or stroke. “Coming to the program here at St. Paul’s made me feel hopeful for the first time in a long while. I felt like I could finally get a handle on my health and be in control of what happens to me,” says Fisher. “With the team at St. Paul’s behind me, I have gotten past my plateau, I’ve walked four half-marathons and changed the way my family eats. I feel strong and am looking forward to a long and healthy life.”

One in four Canadians suffer from metabolic syndrome, a combination of risk factors including excess abdominal fat that can increase an individual’s risk of serious heart disease, stroke and Type 2 diabetes. The BC Metabolic Syndrome Program, which opened in 2006, is the first of its kind in Canada and focuses on giving high-risk patients the tools and skills they need to reduce their risk of developing heart disease and diabetes. The program has been such a success that calls have come from as far away as Nova Scotia from hospitals interested in replicating the innovative and multidisciplinary, nurse-managed, physician-supported program.

“The goal of this clinic is to set the standard for appropriate metabolic syndrome care in Canada and around the world,” says Dr. Andrew Ignaszewski, co-founder of the program and Division Head of Cardiology at St. Paul’s/Providence Health Care. “Our activities – and core philosophy – focus on helping individuals set achievable goals and work through their personal challenges to achieve healthy lifestyle changes.”

Thanks to a $1.6 million donation from pharmaceutical partner AstraZeneca Canada, the program is able to offer patients individual and group support. This includes bi-weekly exercise periods as well as lifestyle management assistance with a registered nurse completely free of charge. “The cost was an important factor for me,” says Iva Fisher. “If I had to pay for the time with a nurse as well as exercise classes, I just don’t think I could have afforded it. I don’t think I would have gotten the help I needed.” But after visiting St. Paul’s for one year. Iva is now better informed about what foods to eat and what exercises will keep her heart healthy. “My doctor has told me that my metabolic syndrome is back under control and my risk of heart attack and stroke are much lower,” adds Iva.

To be eligible for the program patients must demonstrate metabolic syndrome as defined by the International Diabetes Federation and have no history of cardiovascular disease, peripheral vascular disease or treated type 2 diabetes. This criterion requires the presence of high waist circumference along with two other cardiovascular risk factors.

Programs at the B.C. Metabolic Syndrome Clinic incorporate four main objectives to help patients meet their targets:

Lifestyle management – To help patients better understand their illness and the risks the program offers 16 education sessions with speakers from a wide array of expertise. The sessions range from relapse prevention to dealing with the holidays.

Physical activity – Patients may know that physical activity is important to their heart health, but they’re often not sure of exactly what activities will give them the most benefit.

Nutrition education – By understanding what goes into their bodies patients at the Metabolic Syndrome Program are better able to manage their risk factors. Patients learn how to read nutrition labels and plan their weekly diet better.

Motivation – Perhaps most important in managing heart health is setting and understanding specific health targets, such as your Cholesterol Ratio. The clinic works with patients to set these targets and to help maintain the motivation needed to meet them.

The Metabolic Syndrome Program is working toward the larger goal of establishing metabolic syndrome risk reduction programs in community centres around B.C. as well as working with other provinces to establish a standard of care for those at risk of heart attack or stroke.