Women's Heart Health: Knowledge, Beliefs, and Practices of Canadian Physicians

Abstract

There is a clear need to educate physicians about heart disease in women and its prevention and management. More female-specific research, prevention, and clinical programs will enhance our ability to significantly improve cardiovascular health in Canadian women.

Postpartum Cardiovascular Prevention: The Need for a National Health Systems-Based Strategy

“…A 2017 survey of interdisciplinary health care providers indicated that only 50%-60% were aware of the future CV health risks associated with common pregnancy complications. 9 This result was surprisingly similar to findings reported by Smith and colleagues 10 years earlier, in which approximately 50% of physicians reported referring women after HDP for follow-up care. 10 However, other studies have shown that only 20% of women reported having been counselled on their risks of future CVD.…”

“…Furthermore, many Canadian health care providers were not aware of the existence of these pregnancy-related guidelines. 9 Thus, general awareness among front-line physicians could be improved if recommendations were consolidated in a single document summarizing the highest quality evidence for CV risk factor screening, prevention, and treatment after pregnancy complications.…”

“…1). 9 Primary care is the logical setting for postpartum CV preventive care because of its focus on well-woman care across the lifespan. 18 Primary care also offers the added opportunity for paired visits with the infant for well-baby exams, which might increase a woman's participation in her own follow-up care, thereby shortening the time to CV risk counselling as noted by Gladstone et al 7 Finally, recent evidence shows that the partners of women with pregnancy complications 19 and their offspring 20 are also more likely to either have or develop CV risk factors.…”

The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women—Chapter 3: Patient Perspectives

“…1 Moreover, a lack of awareness among health care professionals was revealed in a 2018 survey of a random sample of 504 Canadian primary care physicians (38%) and cardiologists (32%) who indicated that more men than women die of CVD when in fact, the numbers are approximately equal with CVD being a major cause of death in both sexes. 2 Although there was previous optimism in the United States as public awareness of CVD as a leading cause of death for women increased by an absolute 26% (from 30% to 56%) between 1997 and 2012, 3 unfortunately, the most recently published iteration of the American Heart Association survey concluded that this awareness declined from 2009 to 2019 in all races/ethnicities and ages, except in women older than 65 years. 4 The greatest declines in awareness were among Hispanic (14% decline) and non-Hispanic black (31% decline) women, and in younger women (aged 25-34 years; 19% decline), in whom primordial/primary prevention might be most effective.…”

Golden Age of Medicine 2.0: Lifestyle Medicine and Planetary Health Prioritized

“…Physicians have oft-described persistent barriers to the adoption and institutionalization of preventive treatment, education and counseling practices in clinic - described in detail elsewhere, these include lack of time, pressures to handle more pressing issues, lack of resources and perceptions of lack of (convenient) evidence-informed materials, lack of reimbursement or financial incentives, low expectations of benefit, concern about offending patients (e.g. suggesting weight loss), lack of confidence in outcome benefits, and low self-efficacy (confidence in delivering preventive/lifestyle care) [88].…”