Dr. Kerri-Anne Mullen (left) and Dr. Thais Coutinho (middle) meet with Nadia Lappa of the Canadian Women’s Heart Health Alliance. Throughout her work as a patient advocate and a member of the Alliance’s Health Systems and Policy Working Group, Nadia and her colleagues across the country work to identify and promote cost-effective strategies for improving women’s cardiovascular health.

The University of Ottawa Heart Institute (UOHI) is establishing a network to improve cardiovascular disease (CVD) prevention and care in women. The Public Health Agency of Canada (PHAC) and the UOHI Foundation are funding the project, valued at more than $1.2M plus in-kind contributions. 

CVD is the leading cause of death in women over 35 worldwide, accounting for more deaths every year than all cancers combined. So, then, given this alarming truth, why are women still so in the dark when it comes to their heart health? 

Dr. Thais Coutinho heads the UOHI’s Division of Cardiac Prevention and Rehabilitation and chairs the institute’s Canadian Women’s Heart Health Centre (CWHHC), the driving force that powers the Canadian Women’s Heart Health Alliance and their annual Wear Red Canada Day event in February. She said heart disease is declining among men but rising among women. 

“Any step toward closing the gaps to ensure women are as well-informed and well-cared for as men is a giant leap forward,” Coutinho told The Beat. “We want to see more women living longer, healthier lives, more women being proactive about the management of their heart health, more women who can identify their risk factors and prevent heart and vascular disease, and more women who can identify the signs and symptoms of heart disease before it is too late.”

Dr. Kerri-Anne Mullen is program director at the CWHHC and will co-lead the project alongside Coutinho. She said systematic processes for screening and treating cancers early have long been in place, incentivized at many levels, yet there is currently no such system for detecting CVD and its risk factors despite affecting substantially more women in Canada. 

A women’s CVD prevention network will work to improve the awareness of risk factors that disproportionately or uniquely affect women – for example, certain pregnancy-related conditions, autoimmune rheumatic diseases, and menopause. Understanding this, the network will look to systematize processes for prioritizing and tailoring screening, assessment, diagnosis, and treatment of CVD and its risk factors in women.

“We need a better, more informed and integrated system that connects women to resources and interventions in their community earlier, before their conditions progress,” explains Dr. Mullen.

Team members from the CWHHC will support the network at its nucleus. Together, the network will draw on the expertise of cardiovascular specialists, primary care providers, Indigenous and South-Asian healthcare groups, obstetricians, gynecologists, mental health practitioners, physical activity leaders, dietitians, smoking cessation experts, and policymakers across Ontario. 

Women with lived experience, those with and at-risk of CVD, and especially women who are Indigenous, of South-Asian descent, or who have experienced a hypertensive disorder pregnancy (for they are at elevated risk), will support and inform the network across the project timeline.

“Our staff will devote themselves to the background work, completing needs assessments, gathering evidence around the gaps in awareness and care delivery, and investigating whether there are other successful models we can leverage in the design of our network,” said Dr. Mullen. “We’ll be interviewing and surveying people to understand the wants and needs of women and health providers. We want to know what we are doing well, where we can improve, and where the gaps exist.”

The CWHHC and its partners and stakeholders will converge for a thinktank event where key groups will review background information, define problems, brainstorm, and prioritize ideas and solutions for moving forward. It is the aim of the CWHHC to identify key projects to then prototype and pilot. 

Some anticipated examples of such projects include developing awareness products, educational resources, female-specific risk factor screening protocols, management and follow-up algorithms, decision support aids, feedback and reporting structures, practice incentives, infographics, and technology applications. An evaluation period will inform which prototypes are worth developing, scaling, and implementing in the next leg of the project. 

If improving CVD prevention and care for women is going to be a long road, the UOHI’s announcement is a significant step in women’s heart health herstory.

“I think what’s important is that we now have the opportunity to lay much-needed groundwork for some of the implementation work we envision for the future,” said Dr. Mullen. 

The PHAC’s Healthy Canadians and Communities Fund invests in projects that address health inequalities, encourage multi-sectoral participation in chronic disease prevention, and uncover new ways to address the risk factors for chronic disease. The PHAC has awarded upward of $568,000 in support to the project, which the UOHI Foundation has matched.