Transcript: Women And Heart Disease | May 17, 2000

(music plays)
The opening sequence shows a wooden table with a small lit candle as several words fly by: Nutrition, medicine, prevention, treatment, health.
Fast clips show different sets of hands performing activities on the table such as pulling petals from a daisy, drawing a big red heart, tuning a violin, flipping through the pages of a book, cooking, and pouring a glass of red wine.
In animation, the title appears inside the shape of a house: “More to life.”

Then, Karen appears in the studio. She sits in a studio with yellow walls and a small TV set in the background, which reads “More to life.”

Karen is in her late thirties with short black hair and bangs. She’s wearing a pink blazer.

Karen says HELLO.
I'M KAREN HORSEMAN SITTING IN
FOR MAUREEN TAYLOR.
WELCOME TO “MORE TO LIFE.”
ONLY 19 percent OF WOMEN WERE AWARE
OF THEIR RISK OF HEART DISEASE
AND STROKE.
THAT MEANS A MAJORITY OF THE
WOMEN IN THIS COUNTRY ARE
STILL IN THE DARK.
THEY ARE NOT AWARE OF WHAT
COULD HAPPEN WITH THIS
DISEASE.
THAT'S WITH 40,000 OF WOMEN IN
THIS COUNTRY DYING EACH YEAR
OF HEART DISEASE AND STROKE.
WHAT CAN WE DO ABOUT
PREVENTION, AWARENESS, TO
PROTECT OURSELVES.
WE'RE TALKING ABOUT HEART
HEALTH WITH DOCTOR BETH ABRAMSON.
SHE'S A RESEARCHER AT THE
HEART AND STROKE FOUNDATION.
IF YOU HAVE ANY QUESTIONS, YOU
CAN GIVE US A CALL RIGHT HERE
IN TORONTO.

A caption appears on screen. It reads “416-848-2727. 1-888-411-1234.”

Karen continues LONG DISTANCE IS TOLL-FREE.

The caption changes to “moretolife@tvo.org.”

Karen continues OR YOU CAN E-MAIL US AT
MORETOLIFETVO.ORG.
THE STATS ARE SO ALARMING.
FOR SO LONG IT WAS CONSIDERED
SOMETHING THAT ONLY MEN HAD TO
WORRY ABOUT.

Doctor Beth is in her late thirties with shoulder-length blond hair and bangs. She’s wearing glasses, a pastel yellow jacket and a light shirt.

Beth says WE'VE KNOWN FOR THE LAST
TEN YEARS AT LEAST THAT HEART
DISEASE AND STROKE IS THE
LEADING CAUSE OF DEATH IN
CANADIAN WOMEN.
IT'S AN ISSUE THAT WOMEN NEED
TO BE AWARE OF.

The caption changes to “Doctor Beth Abramson. Cardiologist.”

Beth continues WOMEN ARE LIVING LIKE MEN AND
WOMEN ARE DYING LIKE MEN.
WE ARE TREATING AS WE ARE
TRYING TO AND I WANT TO GET
THE MESSAGE OUT TO WOMEN OF
CANADA THEY NEED TO BE AWARE
OF RISK OF HEART DISEASE AS
BROTHERS AND HUSBANDS AND
SONS.
WOMEN NEED TO BE AWARE IT'S
THEIR NUMBER ONE HEALTH
THREAT.

Karen says NUMBER ONE HEALTH THREAT.
TO THINK UP TO ALMOST 1990 IT
WAS BELIEVED THAT WOMEN WERE,
QUOTE, PROTECTED UNTIL WE HIT
MENOPAUSE.

Beth says WELL, WOMEN ARE PROTECTED
FOR THE MOST PART UNTIL THEY
HIT MENOPAUSE.
IT'S NOT A NATURAL DISEASE OF
AGING.
WOMEN'S RISK OF HEART DISEASE
INCREASES TREMENDOUSLY AFTER
MENOPAUSE.
AFTER MENOPAUSE THE RISK OF A
CORONARY VALVE DISEASE IS LOW
IN MEN AND LOW IN GENERAL.
AS WOMEN AGE, AS NATURAL
ESTROGEN LEVELS FALLS, THE
BODY CHANGES AND RISK OF HEART
DISEASE GOES WAY UP.
WOMEN HAVE TO LEAD HEART
HEALTHY LIVES BEFORE MENOPAUSE
TO CONTINUE IT DURING
MENOPAUSE AND AFTER MENOPAUSE.

Karen says AND WHAT ARE THE
DIFFERENCES THEN BETWEEN MEN
AND WOMEN?
WE TALKED ABOUT MENOPAUSE AS A
BIGGIE.
WE -- AS YOU SAID, WE DIE THE
SAME AS MEN OF THIS DISEASE,
WHICH IS ALARMING.

Beth says BWE'RE STARTING TO LIVE THE
SAME AS MEN.

Karen asks WHAT DO YOU MEAN?

Beth replies RISK FACTORS FOR HEART
DISEASE THAT COULD BE
CORRECTED AND PREVENT HEART
DISEASE ARE COMMON IN WOMEN
AND MEN.
BUT 40 YEARS AGO, WOMEN WERE
SMOKING LESS THAN MEN.
YOUNG WOMEN NOWADAYS SMOKE AS
MUCH AS MEN.
IF THE NUMBERS KEEP UP, THEY
WILL BE INCREASING THE RATE OF
SMOKING.
WOMEN SMOKE FOR DIFFERENT
REASONS THAN MEN.
THERE IS A LOT OF RESEARCH TO
SUGGEST THAT.
WE HAVE TO HELP WOMEN, AS OUR
MALE PATIENTS, REDUCE RISK OF
HEART DISEASE BY BUTTING OUT,
BY LEADING HEART HEALTHY
LIVES.
WE'RE ALL ON THE RUN.
WE'RE ALL UNDER STRESS.
WE GRAB FATTY FOOD SOMEWHERE
AT A FAST FOOD CHAIN.
AND WE HAVE A BAD LIFESTYLE IN
GENERAL IN NORTH AMERICA AND
IN CANADA.
AND WOMEN, AS MEN, ARE
UNDER-FIT.
WE ARE NOT DOING REGULAR
ROUTINE EXERCISE.
WE ARE NOT DOING SOME OF THE
SIMPLE RESEARCH WE KNOW FROM
THOUSANDS OF WOMEN THAT
REGULAR EXERCISE DAILY DOESN'T
EVEN HAVE TO BE DAILY, 20 TO
30 MINUTES AT A TIME, A WOMEN
OF THREE DAYS A WEEK WHERE
YOU'RE JUST WALKING SO YOU'RE
GOING ON A POWER WALK AND
BREAKING OUT INTO A SWEAT OR
DOING SOME GARDENING OR
RUNNING AROUND SOMEWHERE.
YOU DON'T HAVE TO GO TO THE
AEROBICS CLASS.
THAT REDUCES YOUR RISK OF
DYING FROM HEART DISEASE.

Karen says YOU SAID IT TWICE WITH THE
IDEA THAT WE'RE LIVING THE
SAME AS MEN.
WITH SO MANY WOMEN NOW GOING
DOWN THE CAREER PATH AND
SUGGESTING THAT OUR LIVES ARE
AS STRESSFUL AS MEN'S, NOT TO
SUGGEST A STAY-AT-HOME MOM'S
LIFE ISN'T STRESSFUL AS WELL,
THERE ARE THE DIET CHANGES AND
AMOUNT OF TIME WE MAY SPEND IN
TERMS OF GIVING OURSELVES BACK
SOMETHING LIKE EXERCISE.

Beth says THAT'S AN ISSUE.
WOMEN ARE TRADITIONALLY
CARE-GIVERS IN SOCIETY.
WOMEN TAKE CARE OF THEMSELVES
LAST, AND I'M GENERALIZING.
THERE'S THE TYPE-E PERSONALITY
THAT WOMEN ARE EVERYTHING TO
EVERYONE EXCEPT THEMSELVES.
WE KNOW WOMEN COME IN LATER TO
THE EMERGENCY ROOM WITH CHEST
PAIN AND COME IN LATER AFTER A
HEART ATTACK.
I JUST CAME BACK FROM THE
FIRST INTERNATIONAL CONFERENCE
ON WOMEN HEART DISEASE AND
STROKE.
IT WAS OUT IN VICTORIA, AND IT
WAS FOR RESEARCHERS,
PHYSICIANS AND POLICY MAKERS.

Karen says THAT'S SOMETHING UNTO
ITSELF.
IT'S THE FIRST EVER.

Beth says ABSOLUTELY.
THERE WERE A LOT OF GOOD SIGNS
PRESENTED AT THAT MEETING.
ONE OF THE STUDIES PRESENTED
CONFIRMS WHAT PREVIOUS STUDIES
SHOW.
WOMEN COME IN LATER TO THE
EMERGENCY ROOM WITH CHEST
PAIN.

Karen asks BECAUSE WE PUT OUR KIDS
FIRST?

Beth replies THERE ARE SEVERAL REASONS
FOR IT, HARD TO KNOW WHY.
ONE OF THE REASONS IS WOMEN
THINK OF IT AS A MAN'S
DISEASE.
THEY DON'T THINK THE PAIN
COULD BE COMING FROM THE
HEART.
IT'S THE OLDER WOMAN WHO COMES
IN WITH HER HEART ATTACK MAY
NOT WANT TO BOTHER SOMEBODY.

Karen says WHEN YOU'RE TALKING ABOUT
PHYSICAL FITNESS EARLIER,
WHAT'S CHANGED I NOTICED WITH
MY GENERATION COMPARED TO MY
MOM'S, MY MOM BEING A SINGLE
MOM, DOING EVERYTHING, DIDN'T
EXERCISE.
IT WASN'T A PRIORITY.
IF I SAW MY MOM ON A BIKE, IT
WOULD HAVE BEEN A VERY STRANGE
SIGHT.
NOW YOU GET WOMEN IN THEIR 30s
LIKE ME, FOR MY KIDS TO SEE ME
BIKING IS A NORMAL THING.
THAT HAS TO BE GOOD.

Beth says THAT'S DEFINITELY GOOD.
WE HAVE TO GET MORE PEOPLE IN
SOCIETY DOING IT AND YOU'RE
SETTING A GREAT EXAMPLE.

Karen says DO YOU SEE IT YOURSELF?
I SEE WOMEN DOING MORE THINGS
DOING MORE.

Karen says WHAT I SEE IS A SKEWED VIEW
OF THE WORLD.
IN THE PREVENTION CENTRE WHERE
I WORK, FOR SOME REASON WE
HAVE A LOT OF HIGHLY EDUCATED
PATIENTS COMING TO US.
THERE'S A GROUP OF PATIENTS
WHO WE'RE NOT SEEING, WHO
YOU'RE NOT CROSSING ON THE
BICYCLE PATH.
THERE'S A MESSAGE OUT THERE
THAT'S GETTING TO SOME
INDIVIDUALS.
STUDIES SUGGEST WE'RE A PRETTY
UNFIT SOCIETY.

Karen says JUST 20 MINUTES THREE TIMES
A WEEK CAN DO A LOT.
WE'RE TALKING HEART HEALTH.
TAKING QUESTIONS ABOUT HEART
DISEASE PREVENTION AND THINGS
YOU CAN DO ABOUT AWARENESS AND
HOW TO MAKE CHANGES TO YOUR
LIFE.
WE HAVE LOTS OF GROUND TO
COVER AND WE CAN TAKE YOUR
QUESTIONS HERE.
OUR GUEST IS DOCTOR BETH ABRAMSON
A CARDIOLOGIST AT SAINT MIKE'S
HOSPITAL IN TORONTO.
OUR PHONE NUMBERS ARE:

The two phone numbers reappear.

Karen continues LET'S START OFF WITH SHERRY
CALLING FROM THUNDER BAY.
HI, SHERRY.

Sherry says HI.
MY MOTHER HAD A HEART ATTACK
IN HER 50s.
I'M NOW 44 AND I WONDER HOW
MUCH HEREDITARY PLAYS A ROLE.
I'M OVERWEIGHT AND I'M A
SMOKER.

Beth says YOUR RISK OF HEART DISEASE
IS SOMEWHAT PREDETERMINED BY
YOUR GENES, YOUR PARENTS, YOUR
FAMILY HISTORY.
WE CAN'T CHANGE OUR PARENTS.
YOU MAY NOT WANT TO.
YOU CAN'T CHANGE YOUR FAMILY
HISTORY.
WHAT WOMEN NEED TO KNOW IS IF
A FAMILY MEMBER WHO IS CLOSE
TO THEM, IN OTHER WORDS A
SISTER OR A BROTHER OR A
PARENT, HAD EARLY HEART
DISEASE, IN OTHER WORDS IN
YOUR MOTHER'S CASE, WE TALK
ABOUT EARLY BEING A WOMAN IN
HER 50s.
SO A WOMAN UNDER 60 OR A MAN
IN HIS 40s OR UNDER 50 -- AND
THERE'S A DIFFERENCE IN AGE
BECAUSE WOMEN DEVELOP HEART
DISEASE ON AVERAGE TEN YEARS
YOUNGER.
IF YOU HAVE A CLOSE FAMILY
MEMBER WHO HAS EARLY HEART
DISEASE YOUR RISK IS
INCREASED.
IT DOESN'T MATTER IF YOU'RE A
MAN OR WOMAN, AND IT DOESN'T
MATTER IF THAT FAMILY MEMBER
IS YOUR MOTHER OR FATHER.
THAT PUTS YOU AT INCREASED
RISK.
YOU HAVE TO MAKE SURE YOUR
OTHER RISK FACTORS ARE CHECKED
OUT.
YOU HAVE TO MAKE SURE YOUR
BLOOD PRESSURE IS CHECKED.
YOU NEED TO MAKE SURE AT LEAST
ONCE IN YOUR LIFE BEFORE THE
MENOPAUSE WITH YOUR EARLY
FAMILY HISTORY AND CERTAINLY
AFTER MENOPAUSE THAT YOUR
CHOLESTEROL IS SCREENED AND
CHECKED.
MAKE SURE YOU DON'T HAVE SIGNS
OR SYMPTOMS OF DIABETES, AND
YOU NEED TO MAKE SURE YOU'RE
NOT SMOKING.
IF YOU ARE SMOKING GET HELP IN
STOPPING SMOKING.
WE HAVE TO MAKE SURE YOU ARE
PHYSICALLY ACTIVE NOW AND
WATCHING THE FAT IN YOUR DIET
LIVING A HEART HEALTHY LIFE
NOW.

Karen says IS THERE A FORMULA BECAUSE
SHERRY HAS THE BACKGROUND,
FAMILY HISTORY, A SMOKER AND
OVERWEIGHT, IS THERE STATISTICS
THAT SHOW SHE GOES INTO A
CERTAIN CATEGORY IN TERMS OF
RISK?

Beth says ABSOLUTELY.
WITH RISK ONE PLUS ONE DOESN'T
EQUAL TWO.
ONE PLUS ONE CAN BE FIVE OR
SIX.
SO IF YOU'RE A SMOKER -- AND
SMOKING AND DIABETES, FOR
EXAMPLE, ONE PLUS ONE IS A
THOUSAND AS FAR AS I'M
CONCERNED.
THE RISKS ADD UP MORE THAN
THEIR SUM.
YOU HAVE TO BE VERY CAREFUL.
IF YOU HAVE A FAMILY HISTORY
OF HEART DISEASE, YOU HAVE TO
AVOID ALL OTHER PREVENTABLE
RISKS FOR HEART DISEASE.

Karen says I HEARD THIS QUESTION ASKED
OFTEN AND IT CAN CHANGE
DEPENDING ON THE EXPERT.
HOW MUCH IS LIFESTYLE, HOW
MUCH IS DIET AND HOW MUCH IS
GENETICS?
WE HEAR SO MUCH MORE ABOUT
GENETICS NOW.
SOME SAY I CAN'T DO MUCH ABOUT
IT.
IT'S IN MY FAMILY HISTORY.
IT'S DEVASTATING BUT I'M
PREDISPOSED TO IT SO I CAN'T
CHANGE TOO MUCH IN MY LIFE.

Beth says CORONARY ARTERY DISEASE IS
A VERY COMPLEX DISEASE
PROCESS.
THERE ARE LIKELY MANY FACTORS
THAT CONTRIBUTE TO THE
DISEASE.
JUST THE SAME WAY WE HAVE MANY
TREATMENTS FOR THE DISEASE.
IN TERMS OF PREVENTION, IF
YOU'RE AT INCREASED RISK FROM
A GENETIC POINT OF VIEW, YOU
HAVE TO LOOK AT YOUR
ENVIRONMENT AND YOUR OWN
LIFESTYLE AND YOUR OWN
INHERENT RISKS.
THE TWO WORK HAND-IN-HAND.
I WOULDN'T SAY FORGET IT, IT'S
IN MY FAMILY.
THAT WOULD PUT YOU UP AS
ANOTHER STATISTIC.

Karen says YOU DON'T WANT TO SAY RUN
YOUR LIFE, MY DAD HAD A HEART
ATTACK, I WILL HAVE ONE.
YOU DON'T WANT TO LIVE LIKE
THAT.

Beth says WE HAVE PATIENTS
UNFORTUNATELY WHO HAVE HAD
CARDIAC PROBLEMS BECOME
CARDIAC CRIPPLES.
IF YOU HAVE A FAMILY MEMBER
WITH EARLY HEART DISEASE, YOU
SHOULDN'T LEAD A TERRIFIED
LIFE BUT A HEART HEALTHY LIFE.

Karen says GO TO JOY CALLING FROM
THORNHILL WITH HER QUESTION.

Joy says HI.
I'M CALLING TO ASK ABOUT WHAT
THE IDEAL PULSE RATE IS TO
START OFF AN EXERCISE
PROGRAMME.
I AM IN MY 70s AND JUST BOUGHT
A TREADMILL TO HELP.

Beth says OKAY.
WELL, JOY, I HAVE A FEW
ANSWERS FOR YOU.
NUMBER ONE, I'M NOT YOUR
PHYSICIAN OVER THE PHONE, SO I
WON'T GO INTO A LOT OF DETAILS
IN YOUR PARTICULAR CASE.
IF YOU ARE OTHERWISE HEALTHY
DO WHAT YOU CAN DO UNTIL YOU
ARE SHORT OF BREATH AND WORK
YOUR WAY UP SLOWLY.
IT'S A GENERAL COMMON SENSE
ISSUE.
IF YOU DO HAVE UNDERLYING
HEART DISEASE, YOU SHOULD SEE
YOUR FAMILY DOCTOR ABOUT
GIVING YOU THE APPROPRIATE
EXERCISE PRESCRIPTION.
IF YOU ARE SOMEBODY WHO HAS
ANGINA OR HAS HAD A MAJOR
HEART PROBLEM.
IF YOU'RE OTHERWISE HEALTHY OR
HAVE HEALTH PROBLEMS THAT
AREN'T RELATED TO YOUR HEALTH
LIKE ARTHRITIS, AND MANY WOMEN
HAVE ARTHRITIS THAT DON'T
ALLOW YOU TO EXERCISE TO THE
EXTENT YOU WANT TO.
DO SOMETHING SO YOU'RE
BREAKING OUT INTO A SWEAT.
DON'T WORRY TOO MUCH ABOUT
YOUR PULSE.
IF YOU'RE OUT OF SHAPE, IT
WILL GO UP QUICKLY.
THAT WILL COME DOWN WITH
REGULAR, ROUTINE EXERCISE.

Karen says DON'T GET CAUGHT UP IN THE
PULSE.
THAT RULE OF THUMB TO BE ABLE
TO TALK OUT LOUD, EVEN IF
YOU'RE ON A TREADMILL BY
YOURSELF.
WORK UP THE SWEAT BUT DON'T
OVERDO IT.

Beth says WE TALK ABOUT WALKING AND
TALKING.
IF YOU CAN WALK AS YOU'RE
TALKING, THAT'S A GOOD THING.
AND, YOU KNOW, THE OTHER THING
I GIVE TO YOU AS ADVICE AS
WELL AS MANY OTHER LISTENERS,
DON'T BEAT UP ON YOURSELF.
START LOW, GO SLOW AND BUILD
IT INTO YOUR EVERYDAY ROUTINE.
I THINK IT'S GREAT YOU BOUGHT
A TREADMILL.

Karen says A WOMAN IN HER 70s BUYING A
TREADMILL.

Beth says I HAD A PATIENT E-MAIL IN
HER 80s THANKING US.

Karen says YOU MENTIONED ANGINA.
WANT TO GET INTO THE TERMS.
WE HEAR HEART DISEASE.
IT'S A BROAD GENERALIZATION IN
TERMS OF A LABEL.
LET'S TALK ANGINA, WHAT THAT
MEANS.

Beth says I WILL BACK UP AND TALK
ABOUT HEART DISEASE.
WHEN WE DISCUSS HEART DISEASE
WHAT WE REFER TO IS CORONARY
HEART DISEASE OR CORONARY
ARTERY DISEASE WHERE THERE'S A
NARROWING OR BLOCKAGE OF BLOOD
FLOW TO THE HEART.
THAT NARROWING OR
ATHEROSCLEROSIS CAN LEAD TO
HEART ATTACK.

Karen asks WILL YOUR MODEL HELP US
WITH THAT?

Beth replies THIS IS A HEART.
YOU CAN SEE THERE ARE
DIFFERENT PARTS OF THE HEART.
WHAT YOU MIGHT SEE IS THERE'S
A BLOOD SUPPLY ON THE OUTSIDE
OF THE HEART.
WHAT HAPPENS WITH BAD
LIFESTYLE, BAD GENES, BAD
CHOLESTEROL, SOMETIMES BAD
LUCK YOU GET A NARROWING OR
BLOCKAGE OF THE HEART.
WHEN THAT NARROWING OCCURS,
WHAT MAY HAPPEN -- I DON'T
KNOW IF THE MODEL WILL SHOW IT
ALL THAT WELL, THE HEART
MUSCLE CAN DIE.

Beth opens the model and continues
THAT DEATH OF A HEART MUSCLE
IS A HEART ATTACK.
WE CALL IT A MYOCARDIAL
INFARCTION.
BUT IT'S A HEART ATTACK.
THAT BLOCKAGE OF THE HEART
MUSS -- BLOOD SUPPLY OF THE
HEART MUSCLE IS PART OF THE
PROCESS IS A BLOOD CLOT.
WE HAVE SOPHISTICATED
MEDICATIONS NOW THAT WE CAN
GIVE TO PEOPLE TO OPEN UP THE
BLOOD CLOTS.
IT'S A CLOT-BUSTING
MEDICATION.
IF YOU'RE HAVING A SEVERE
DISCOMFORT IN YOUR CHEST, AN
ELEPHANT SITTING ON YOUR CHEST
THAT IS NOT GOING AWAY, GET TO
THE NEAREST EMERGENCY ROOM BUS
WE HAVE CLOT BUSTING MEDICINE
IF IT IS A HEART ATTACK.
THE ANGINA IS SAYING THE HEART
IS NOT GETTING ENOUGH BLOOD.
HOW IT CRIES OUT IS IN THE
FORM OF CHEST DISCOMFORT.
USUALLY TIGHTNESS OR HEAVINESS
IN THE CHEST.
WOMEN AS IN MEN, PATIENTS GET
A DISCOMFORT NOT JUST THE
CHEST BUT THE THROAT, THE JAW,
THE SHOULDER BLADES OR DOWN
THE ARMS, QUITE OFTEN THE LEFT
ARM.
USUALLY ANGINA OR DISCOMFORT
FROM YOUR HEART -- THE WORD
REALLY MEANS CHEST PAIN, IS A
DISCOMFORT THAT COMES ON WITH
EXERCISE AND GOES AWAY WITH
REST.
IF ANYBODY IS HAVING SYMPTOMS
THAT'S COMING ON WITH EXERCISE
AND GOING AWAY FROM REST, IT
MAY NOT BE COMING FROM YOUR
HEART BUT WORTH GETTING
CHECKED OUT THROUGH YOUR
FAMILY DOCTOR.

Karen says THERE'S A VARIETY OF
REASONS THAT COULD CAUSE THE
BLOCKAGE.
IT COULD BE GENETICS OR YOUR
DIET.
I WANT TO GET BACK TO THE IDEA
OF THE GENETICS.
I WAS READING AN ARTICLE ABOUT
THE MUTATION OF THE GENE THAT
KEEPS THE GOOD CHOLESTEROL AND
BUILDS UP THE BAD CHOLESTEROL.
AND THEY CALL IT LIKE THIS
GENE MATCH MAKER.
IF THAT WILL CAUSE THE
BLOCKAGE, CAN THEY MAKE SURE
OUR HEART IS ACTING PROPERLY?
CAN THE DRUGS CREATE THE HEART
TO FUNCTION IN A BETTER WAY?

Beth says OUR CARDIAC DRUGS DO MANY
THINGS.
WE'RE TALKING ABOUT PREVENTING
THE BLOCKAGE OR NARROWING FROM
OCCURRING.
YOU'RE RIGHT, GENES DO PLAY A
ROLE.
THERE ARE OTHER FACTORS THAT
PLAY A ROLE WITH THE GENES.
THE GENES ARE A LOT OF THE
STORY.
THEY'RE NOT ALL OF THE STORY.
ALL THE LIFESTYLE FACTORS WE
ALLUDED TO TODAY DO CONTRIBUTE
TO A BUILDING UP OF
CHOLESTEROL AND BASICALLY JUNK
IN THE BLOOD VESSEL WALL.
WHEN YOU HAVE THAT NARROWING,
WE HAVE THAT NARROWING, YOU
MAY HAVE SYMPTOMS.
SOME OF OUR MEDICATIONS ARE
USED TO TREAT THE SYMPTOMS.
THEY MAY OPEN UP THE ARTERY A
LITTLE, THE BLOOD FLOW TO THE
HEART.
THEY MAY TRY AND REDUCE THE
WORKLOAD ON THE HEART OR THE
STRESS ON THE HEART BY SLOWING
THE HEART DOWN OR TAKING THE
LOAD OFF THE HEART, MAKING THE
BLOOD PRESSURE LOWER.
THOSE ARE ALL THINGS THAT HELP
ONCE ONE HAS A PROBLEM.
THERE ARE MANY OTHER THINGS WE
CAN DO IN TERMS OF LIFESTYLE
AND MEDICATIONS THAT ACTUALLY
PREVENT THAT NARROWING FROM
PROGRESSING OR OCCURRING IN
THE FIRST PLACE.

Karen says LET'S GO NEXT TO LOUISE --
SORRY, SUSAN CALLING FROM
TORONTO.
HI, SUSAN.

Susan says HI.
YEAH, I HAVE HAD SOME SYMPTOMS
OF HEART PROBLEMS, BUT IT
DOESN'T SEEM TO BE SHOWING
UP -- I HAD AN IRREGULAR BEAT
SLIGHTLY SHOW UP ON A HEART
MONITOR.
I JUST WORE A HEART MONITOR
AGAIN LAST WEEK.
AND I'VE HAD SEVERE LIKE A
SKIPPING WHEN I'M RESTING, AND
THEN WHEN I'M SLEEPING, WAKING
ME UP IN THE NIGHT AND IN THE
MORNING, ABSOLUTE POUNDING.
I'M WONDERING, I HAD FIVE
CHILDREN AND TWO C-SECTIONS.
I HAD A PROBLEM WITH A LEG
VAIN YEARS AGO.
MY ARTERY WAS OVER MY OVARY
AND CAUSING SEVERE KICKING.
IF I HAVEN'T GOTTEN THE
RESULTS BACK FROM THE LAST
MONITOR TEST, BUT I WASN'T
SHOWING THE SYMPTOMS THEN.
I WAS SITTING DOWN.
SHOULD I JUST BE INSISTING ON
WEARING THE HEART MONITOR SORT
OF THROUGHOUT THE WEEK?
AND ALSO I WANTED TO ASK YOU
ABOUT --

Karen says I JUST WANT TO CUT IN HERE,
I WANT TO RE-EMPHASIZE IT'S
DIFFICULT FOR BETH TO MAKE
JUDGMENTS OVER THE PHONE.
SHE WILL TALK IN
GENERALIZATIONS, AND SHE HAS A
LOT TO ADDRESS BECAUSE YOU
TOUCHED ON A LOT.

Beth says I THINK YOU BRING UP SOME
INTERESTING ISSUES.
AND I'M GOING TO ASK YOU TO GO
BACK TO YOUR FAMILY DOCTOR AND
TALK ABOUT SPECIFICS.
YOU TALK ABOUT HEART POUNDING
AND EXTRA BEATS.
THAT IS A VERY COMMON PROBLEM
IN MANY PEOPLE IN THE
POPULATION.
WHAT I WANT TO TRY AND
EMPHASIZE, AND I THINK IT'S AN
IMPORTANT MESSAGE TO GET OUT,
WHEN WE TALK ABOUT HEART
DISEASE BEING ONE OF THE
LEADING CAUSES OF DEATH IN
CANADIAN WOMEN AS WELL AS
CANADIAN MEN, WE ARE TALKING
ABOUT CAR NARY -- CORONARY
ARTERY DISEASE OR BLOCKAGES.
WE TALK ABOUT THEM BEING THE
SAME THING.
THE HEART IS A COMPLEX ORGAN.
THERE IS A BLOOD FLOW TO THE
HEART.
THE HEART IS MUSCLE, IT'S A
PUMP.
THERE'S AN ELECTRICAL SYSTEM
TO THE HEART.
THE HEART BEING A HOUSE, YOU
SOMETIMES NEED PLUMBERS OR
ELECTRICIANS OR SOMEBODY TO
PUT A PATCH IN THE WALL.
BUT NOT ALL OF THESE PROBLEMS
WITH THE HEART OR ISSUES
RELATED TO THE HEART HAVE THE
SAME IMPORTANCE OR SAME
SERIOUSNESS IN TERMS OF THE
HEART DISEASE WE'RE TALKING
ABOUT.
WHEN YOU'RE TALKING ABOUT
PALPITATIONS IN GENERAL, IN
GENERAL THEY ARE USUALLY
BENIGN OR NOT SERIOUS.
AND IN GENERAL, THEY ARE
NUISANCE PROBLEMS THAT DO NOT
RELATE TO WHAT WE WERE TALKING
ABOUT EARLIER, WHICH IS HEART
DISEASE AND STROKE KILLING
CANADIAN WOMEN.
I THINK IT IS IMPORTANT TO
TAKE A STEP BACK, THAT IF
SOMEONE IS OTHERWISE HEALTHY,
AND THEIR HEART MUSCLE IS
SQUEEZING NORMALLY, AND THEY
DON'T HAVE CORONARY ARTERY
DISEASE, IN GENERAL,
PALPITATIONS AND FEELING
SKIPPED BEATS IS QUITE COMMON,
QUITE NATURAL.
IN FACT 5 percent OF THE POPULATION
WILL FEEL EXTRA BEATS.
I HAVE PATIENTS OFTEN COME IN,
DOC, I FEEL AN EXTRA BEAT AND
IT STOPS.
THEY'RE TERRIFIED THEIR HEART
IS STOPPING.
THAT'S A NATURAL FEAR.
THE TRUTH IS THE BODY'S
NATURAL AND THE HEART'S
NATURAL RESPONSE AFTER AN
EXTRA BEAT IS SLOW DOWN, CATCH
UP AND CONTINUE ON.
IT'S NORMAL TO FEEL A PAUSE.
PEOPLE FEEL PAUSES AND EXTRA
BEATS.
IT'S USUALLY NOTHING SERIOUS.

Karen says SUSAN WAS TALKING A LOT
ABOUT HER HISTORY WITH TWO
C-SECTIONS AND A VEIN IN HER
LEG.
YOU TALK ABOUT THE HEART BEING
LIKE A HOUSE.
IF WE HAD WORK DONE ON OUR
HOUSE, COULD IT BE THAT
BECAUSE I'VE HAD THIS --

Beth says ABSOLUTELY.
THERE ARE MANY WOMEN I SEE AND
MEN TOO WHO ARE AWARE OF THEIR
BODIES.
WHEN YOU'VE HAD SOME CONTACT
WITH THE HEALTH CARE SYSTEM,
YOU MAY BECOME MORE AWARE OF
OUR BODY, AWARE OF YOUR HEART
BEATING.
OFTEN IT'S NOT THAT SERIOUS.

Karen says LOUISE IN O

MEENA PATHAK IS NEXT.
HI, LOUISE.
DO WE HAVE LOUISE IN O
MEENA?

Louise says I'M HERE.
I HAVE A QUESTION FOR
DOCTOR BETH.
I WORE A HEART MONITOR LAST
YEAR.
I'M 42 YEARS OLD AND SUDDENLY
BEGAN EXPERIENCING THESE EXTRA
PALPITATIONS AND THUMPING IN
MY CHEST AND SEPTEMBER TO A
CARDIOLOGIST AND WORE A HEART
MONDAY FOR FOR 24 HOURS.
THAT'S WHAT THEY TOLD ME IT
WAS BENIGN BEATS.
I READ AN ARTICLE IN THE
DOCTOR'S OFFICE THAT YOU WERE
TALKING ABOUT SYMPTOMS OF
HEART ATTACKS, THAT SYMPTOMS
CAN OFTEN BE COMPLETELY
DIFFERENT FROM MEN, THAT OFTEN
DON'T OFTEN GET THE EXPERIENCE
OF THE TIGHTENING IN THE
CHEST.
A LOT OF TIMES IT'S A
STOMACHACHE AND NOTHING MORE.
I WONDER IF THERE'S ANY TRUTH
TO THAT, AND IF SO, WHAT WOULD
THE SYMPTOMS FOR WOMEN BE?

Beth says WHEN YOU TALK ABOUT
DIFFERENCES BETWEEN WOMEN AND
MEN, IT IS SAID -- AND I WANT
TO DISPEL THE MYTHS NOW --
THAT WOMEN HAVE MORE UNUSUAL
SYMPTOMS THAN MEN.
THE TRUTH OF THE MATTER IS
THAT WHEN WOMEN PRESENT WITH
HEART RELATED CORONARY ARTERY
DISEASE RELATED SYMPTOMS,
THEIR MOST COMMON COMPLAINT IS
THAT OF CHEST PAIN.
MEN AND WOMEN BOTH COMPLAIN OF
CHEST PAIN.
IT'S THE MOST COMMON SYMPTOM.
IN ADDITION WOMEN HAVE MORE
UNUSUAL SYMPTOMS ABOVE AND
BEYOND THE CHEST PAIN SUCH AS
SWEATING OR FEELING UNWELL OR
BEING SHORT OF BREATH OR
HAVING THROAT, ARM, JAW
DISCOMFORT, BACK DISCOMFORT.
WHEN I SEE A PATIENT MEN OR
WOMEN, I DON'T KNOW WHERE THAT
MYTH CAME FROM.
I'M USING IT AS A MYTH BECAUSE
WE NEED MORE INVESTIGATION
INTO THE AREA.
I THINK IT IS FAIR TO SAY THAT
IN GENERAL, SYMPTOMS, WHATEVER
THEY MAY BE, THAT COME ON WITH
EXERCISE AND GO AWAY WITH REST
NEED TO GET CHECKED OUT.
IN FACT, WHEN A WOMAN OR A MAN
IS PRESENTING WITH A HEART
ATTACK, THE MOST COMMON
SENSATION IS A WEIGHT ON THEIR
CHEST.
I'M GLAD YOU BROUGHT THAT UP.

Karen says LOUISE TALKING ABOUT A
STOMACHACHE, A WOMAN WOULD GET
HER FIRST SIGNS THERE.
THERE'S SO MANY DIFFERENCES.
READING ARTICLES IN THE
DOCTOR'S OFFICE.
Karen laughs and continues JUST READ ABOUT THIS.

Beth says I THINK WOMEN CAN HAVE
ATYPICAL SYMPTOMS, BUT SO TO
MEN.
THAT GENDER DIFFERENCE IS NOT
AS GREAT.
I SUSPECT -- AND IT'S JUST A
HYPOTHESIS THAT WOMEN AND MEN
ARTICULATE THEIR SYMPTOMS
DIFFERENTLY.
I SEE IT IN MY OFFICE ON A
DAILY BASIS.
THE COMMUNICATION IS SOMETIMES
DIFFERENT, AND IT'S JUST -- I
DON'T KNOW WHY THAT IS.
THERE MAY BE SOCIETAL
DIFFERENCES, ENVIRONMENTAL
DIFFERENCES.
THE TRUTH OF THE MATTER IS
WHEN A WOMAN OR MAN IS HAVING
A HEART ATTACK, THE MOST
COMMON SYMPTOM IS CHEST
DISCOMFORT.
YOU KNOW WHAT, LOUISE?
IF YOU'RE CONCERNED YOU ARE
HAVING THOSE SYMPTOMS, IT'S
WORTH TALKING TO YOUR FAMILY
DOCTOR ABOUT SAYING COULD THIS
BE MY HEART?
WHAT ARE TYPICAL SIGNS OF
HEART BS DISEASE.
DO I HAVE HIGH CHOLESTEROL?
WHAT'S MY BLOOD PRESSURE.
DO I HAVE ANY OF THE RISK
FACTORS THAT WOULD MAKE THIS
SYMPTOM MORE SUSPICION.

Karen says KAREN IS NEXT FROM OTTAWA.

A female caller says HELLO.
A QUICK QUESTION.
MY AUNT HAS WHAT SHE BELIEVES
TO HAVE CORONARY ARTERY
DISEASE, ATHEROSCLEROSIS?
HER FATHER DIED OF A HEART
ATTACK -- HE HAD A HEART
ATTACK, SURVIVED AT 62.
SHE HAS A BLOCKED ARTERY AND
DOESN'T WANT TO HAVE AN
OPERATION.
IS THERE ANY WAY OF SCOURING
ARTERIES LIKE DRANO WOULD DO,
WITHOUT SURGERY?

Beth says THAT'S A GOOD QUESTION.
I WILL GENERALIZE AGAIN.
WHEN YOU HAVE A NARROWING OR A
COMPLETE BLOCKAGE TO ONE OF
THE ARTERIES OF YOUR HEART,
YOU HAVE CORONARY ARTERY
DISEASE.
THE TREATMENT IS ONE OF THREE
AND THE COMBINATION OF THE
THREE OPTIONS.
MEDICATIONS WHICH ACTUALLY
FALL INTO ALL TREATMENT
CATEGORIES, AND WE'LL TALK
ABOUT THAT IN A MINUTE AS TO
WHY.
BYPASSING THE NARROWING WITH
SURGERY, AND THAT'S WHAT WE
CALL BYPASS SURGERY, OR
SOMETIMES NOWADAYS WE TAKE A
BALLOON AND OPEN THE NARROWING
WITH WHAT WE CALL CORONARY
ANGIOPLASTY.
WE HAVE FANCY ROTO-ROOTERS OR
LASERS THAT SHOW NOT WORKING
AS WELL AS THE OLD FASHIONED
BALLOON.
THEN WE PUT IN MESH WIRE TO
OPEN UP THE NARROWING.
THE TRUTH IS THE RISK FOR THAT
NARROWING TO COME BACK IS
STILL IN A PERSON WHO
UNDERGOES AN INTERVENTION
OTHER THAN MEDSATIONS. --
MEDICATIONS.

Karen says IT CAN RE-APPEAR.

Beth continues WE HAVE TO MAKE SURE THAT
PATIENT IS ON THE RIGHT
MEDICATIONS TO PREVENT
WORSENING OF THE AND REKURPS
OF THE NARROWING.
SO WE HAVE SLEPT MEDICATIONS
FOR CARDIAC PATIENTS,
INCLUDING CHOLESTEROL
MEDICATIONS.
CHOLESTEROL LOWERING
MEDICATIONS.
STUDY AFTER STUDY AFTER STUDY
SHOWS THAT PATIENTS WHO HAVE
HEART DISEASE WHO ARE AT
HIGHEST RISK OF HAVING
RECURRENT HEART DISEASE ARE
TREATED WITH LOWERING THE
CHOLESTEROL.
RAISE THE GOOD CHOLESTEROL.
MOST PATIENTS NEED TO BE ON AN
ASPIRIN A DAY.
THIS IS NOT PREVENTION.
THIS IS CALL PREVENTION OF THE
DISEASE -- ONCE YOU HAVE THE
DISEASE -- DISEASE LOWERING
RECURRENCE.
BETA BLOCKERS AND NOW GROUPS
OF DRUGS CALLED ACE
INHIBITORS.
THERE IS A NEW STUDY THAT SAYS
THESE ALL HAVE POWERFUL
EFFECTS REDUCING RECURRING
EVENTS.

Karen says I WANT TO TOUCH ON THE
CONTROVERSY AROUND
ACETAMINOPHEN WHETHER IT
SHOULD BE IN THE SAME CATEGORY
AS ASPIRIN.
THERE IS A STUDY SAYING IT'S
DOING WONDERS IN TREATMENT AND
PREVENTION OF HEART DISEASE.

Beth says THEY WORK VERY DIFFERENTLY.
WE USE ASPIRIN IN CARDIOLOGY.
I DON'T RECOMMEND ASPIRIN TO
MEN OR WOMEN WITHOUT HEART
DISEASE.
PEOPLE WITH DIABETES AN
ASPIRIN A DAY IS A GOOD THING.
PEOPLE WITH HEART DISEASE WE
USE ASPIRIN BECAUSE IT AFFECTS
THE PLATELETS.
WE'RE TRYING TO PREVENT A
BLOOD CLOT FROM FORMING.
THE ASPIRIN IS USE TODD MAKE
THE BLOOD THINNER.

Karen says WE HEAR IT CALLED A BLOOD
THINNER.

Beth says THAT'S NOT THE SAME AS AN
ACETAMINOPHEN.
I DON'T USE ASPIRIN FOR
HEADACHES EITHER.
I USE ACETAMINOPHEN FOR
HEADACHES WHEN I GET THEM.
I USE ASPIRIN AS A HEART
MEDICATION TO THIN THE BLOOD,
AFFECT THE PLATELETS.
IF YOU HAVE HEART DISEASE HAD
BYPASS SURGERY OR CONSIDERING
IT, YOU SHOULD BE ON THE
ASPIRIN A DAY.

Karen says ONE OF THE STUDIES WAS
SPONSORED BY TYLENOL.
THEY WANTED THEIR PRODUCT OUT
THERE LIKE ASPIRIN.
IN TERMS OF BETA BLOCKERS,
THERE'S A LOT OF PUBLICITY
AROUND THE FACT THAT BETA
BLOCKERS ARE ABLE TO ALMOST
REPAIR THE HEART.
THIS ONE MAN HIS STORY IS
WELL-PUBLICIZED HE HAS A NEW
LEASE ON LIFE BECAUSE THE BETA
BLOCKER IS FIXING THE DAMAGE
ON HIS HEART.

Beth says WE USE THE BETA BLOCKER FOR
SEVERAL REASONS.
AFTER SOMEONE HAD A HEART
ATTACK TO PREVENT A THURT
FURTHER HEART ATTACK.
IT MAY MAKE THE HEART LESS
IRRITABLE, SLOWS DOWN THE
HEART RATE.
USE IT FOR PEOPLE WHO HAD A
HEART ATTACK.
IF YOU HAVE A WEAKENED HEART
MUSCLE, THAT'S CONGESTIVE
HEART FAILURE, YOU CAN HAVE
CONGESTIVE HEART FAILURE FOR
MANY REASONS.
THE COMMONEST CAUSE IS, IN
FACT, A PREVIOUS HEART ATTACK
OR CORONARY ARTERY DISEASE.
WHATEVER THE CAUSE, CONGESTIVE
HEART FAILURE, WE KNOW BETA
BLOCKERS AS A WHOLE PREVENT
WORSENING OF THE HEART MUSCLE
FAILURE AND CAN MAKE THE HEART
IMPROVE IN FUNCTION.
AND THAT'S PROBABLY BECAUSE IF
YOU HAVE A WEAKENED HEART
MUSCLE, YOU'RE WALKING AROUND
IN A CONSTANT STATE OF STRESS.
IF I SAID BOO TO YOU, YOUR
ADRENALINE WOULD GO UP.
IN SOMEBODY WHO HAS A WEAKENED
HEART MUSCLE, THEY HAVE A
CONSTANT STATE OF INCREASED
ADRENALINE.
IT ALLOWS PEOPLE TO WALK
AROUND AND FEEL OKAY.
WE KNOW ADRENALINE OVER TIME
BOMBARDING THE HEART COULD
CAUSE IT TO WEAKEN FURTHER.
BETA BLOCKERS BLOCK THE
ADRENALINE FROM THE HEART AND
ALLOW THE HEART MUSCLE TO
HEAL.

Karen says THAT'S ENCOURAGING WITH THE
BREAKTHROUGHS.
I WANT TO GIVE YOU OUR PHONE
NUMBERS AND REMIND YOU WE ARE
TALKING ABOUT HEART DISEASE
FOR WEN AND WOMEN.
OUR GUEST IS DOCTOR BETH ABRAMSON,
A RESEARCHER FOR THE HEART AND
STROKE FOUNDATION.
LET'S GO TO TONY CALLING FROM
PETERBOROUGH.
HI, TONY.

Tony says HELLO.
I'M 38 AND I'VE BEEN DIAGNOSED
WITH CARDIOMYION THINK.
AND IT'S ALSO THEY FIGURE ITS
A THE VIRAL TYPE I HAVE COME
DOWN WITH.
CAN YOU TELL ME WHAT'S SOME OF
THE LATEST RESEARCH AS FAR AS
THAT GOES AND PROGNOSIS FOR
IT?
EVERYTHING I'VE BEEN READING
ON THE 'NET IS BASICALLY THE
ACE INHIBITORS AND BETA
BLOCKERS.

Karen says CAN YOU START WITH A
DEFINITION?

Beth says I'M GOING TO BACK UP.
WHAT TONY IS TALKING ABOUT IS
CARDIO IS HEART, MIO IS MUSCLE
AND PATHY IS PROBLEM.
IT'S A HEART MUSCLE PROBLEM.
IT'S WHAT I WAS TALKING ABOUT
WITH THE CONGESTIVE HEART
FAILURE.
CARDIOMYOPATHY IS WHERE THE
PUMP IS NOT WORKING.
IN TONY'S CASE, HIS CAUSE, AS
IN MANY YOUNGER PEOPLE WHO
HAVE THIS RARE CONDITION, IT
MAY BE DUE TO A VIRUS, MAY BE
DUE TO AN INFLAMMATION OF THE
HEART.
WHATEVER THE CAUSE IS THE
TREATMENTS ARE USUALLY THE
SAME.
IN GENERAL, I WOULD ADVISE YOU
TO GO ON -- NOT SPECIFIC
ADVICE, IT SOUNDS LIKE YOU ARE
UP ON THINGS.
IF YOU'RE ON AN ACE INHIBITOR
AND A BETA BLOCKER, THAT'S A
GOOD THING.
GO TO A CREDIBLE WEBSITE OR
GET SOME INFORMATION.
THE HEART AND STROKE
FOUNDATION HAS A VERY GOOD
WEBSITE.
OUR CARDIAC PREVENTION CENTRE
AT SAINT MICHAEL'S HOSPITAL HAS
A GOOD WEBSITE THAT YOU CAN
CLICK ON TO OTHER WEBSITES
THAT ARE INCREDIBLE.
BACKING UP A BIT, THAT'S A
WEAKENING OF THE HEART MUSCLE
FOR VARIOUS REASONS.
IT'S A RARE FORM OF HEART
DISEASE THAN THE CORONARY
HEART DISEASE THAT IS THE
LEADING KILLER.
A THIRD OF PATIENTS GET BETTER
WITH THE TYPE OF CARDIOMYOPATHY
TONY IS TALKING ABOUT, A THIRD
STAY THE SAME AND A THIRD GET
WORSE.
MY ADVICE TO YOU IS IT SOUNDS
LIKE YOU ARE BEING TAKEN CARE
OF BY A COMPETENT INDIVIDUAL.
ASK YOUR HEALTH CARE PROVIDER
ABOUT ONGOING RESEARCH STUDIES
YOU MAY WANT TO PARTAKE IN.

Karen says THANKS FOR THE CALL AND
GOOD LUCK.
WE WERE TALKING ABOUT
MEDICATIONS.
I CANNOT BELIEVE THERE'S A
SUGGESTION NOW THAT HEART
DISEASE COULD BE CAUSED BY A
VIRUS, CATCHING A BUG COULD BE
THE REASON WHY SOME COME DOWN
WITH HEART DISEASE.
THERE ARE DOCTORS -- THERE'S A
DOCTOR WHO HAS A RADIO SHOW IN
THE STATES WHO IS TELLING HIS
LISTENERS TO TAKE ANTIBIOTICS
FOR HEART DISEASE.

Beth says I HAVE COLLEAGUES WHO
THINKS EVERYTHING IS
INFECTIOUS.
THE TRUTH OF THE MATTER IS AS
I SAID EARLIER, HEART DISEASE
IS A VERY COMPLEX PROBLEM.
CORONARY ARTERY DISEASE IS
LIKELY CAUSED BY MANY, MANY
FACTORS.
MIGHT THERE BE A SMALL
COMPONENT DUE TO INFLAMMATION
OR INFECTION?
POSSIBLY.
BUT WE'RE NOT RECOMMENDING
ANTIBIOTICS TO EVERYBODY.
THERE'S WAY MORE BANG FOR YOUR
BUCK IN EXERCISING REGULARLY,
NOT SMOKING, MAKING SURE
YOU'RE LEADING A HEART HEALTHY
LIFESTYLE, MAKING SURE YOUR
BLOOD PRESSURE ISN'T HIGH.

Karen says PRETTY ALARMING TO THINK
THAT YOU CAN CATCH HEART
DISEASE, THAT IT COULD BE A
BUG THAT'S GOING AROUND THE
OFFICE.

Beth says I WOULD THINK THAT'S AN
OVER-SIMPLIFICATION AND I
WOULDN'T WANT YOUR LISTENERS
TO WORRY ABOUT IT.
YOU'RE LIKELY TO CATCH HEART
DISEASE FROM SECONDHAND SMOKE
THAN A BUG.

Karen says DO YOU KNOW SPECIALISTS
PRESCRIBING ANTIBIOTICS?

Beth says I DON'T KNOW ANY COLLEAGUES
THAT ARE.
IT'S PART OF A RESEARCH
PROTOCOL AND NON-TRADITIONAL.

Karen says YOU HAVE HEARD OF THIS
CONCEPT OF THE BACTERIA THAT
MIGHT BE HOUSED IN THE MOUTH
GOING INTO THE BODY AND
CAUSING ALL SORTS OF DIFFERENT
THINGS?

Beth says IT'S AN AREA OF INTEREST
THAT WE HAVE TO DO SOME
RESEARCH INTO.
IT MIGHT END UP TURNING OUT TO
BE ONE OF THE CAUSES OF HEART
DISEASE.
FOR NOW GET OUT THERE, WALK,
DON'T SMOKE.

TAKE AN ASPIRIN, NOT AN
ANTIBIOTIC.

Beth laughs.

Beth says I DON'T ROUTINELY PRESCRIBE
ASPIRIN EITHER.

Karen says LET'S GO TO E-MAIL FROM
CLIFF.
She turns to the computer and reads WITH ALL THIS TALK OF THE
DIFFERENCES OF MEN AND WOMEN
WITH HEART DISEASE, I HEARD
HAVING HIGH TESTOSTERONE
LEVELS CONTRIBUTES.
SLIGHTLY HIGHER RATE IN MALES.
DOCTORS SAY HAVING LOW
TESTOSTERONE IS AN OVERLOOKED
POTENTIALLY RISK FACTOR.

Beth says IT TALKS ABOUT THE SEX
HORMONES AND HEART DISEASE.
IS THERE AN EASY EXPLANATION,
EASY ANSWER, NO.
WE'RE NOT THERE YET.
TESTOSTERONE HAS MANY EFFECTS
ON THE BLOOD VESSELS IN THE
HEART.
IT CAN AFFECT THE CHOLESTEROL
OR FAT, LIPID, BLOOD FAT IN
THE BLOOD.
IT AFFECTS THE BLOOD VESSELS
TO RELAX OR CHI LATE.
ESTROGEN AND TESTOSTERONE
BALANCE EACH OTHER OUT IN MEN
AND WOMEN.
TESTOSTERONE MAY HAVE
BENEFICIAL EFFECTS RELAXING
THE BLOOD VESSELS, BUT THAT
HAS TO BE COUNTERBALANCED ON
EFFECTS ON CHOLESTEROL.
I DON'T HAVE THE ANSWER.
IT'S MY AREA OF INTEREST AND
THE FEMALE SEX HORMONES, I
THINK WE WILL HOPEFULLY GATHER
MORE INFORMATION, HAVE MORE
ANSWERS IN THE NEXT FEW YEARS.
THERE'S NO ANSWER NOW.

Karen says CONFLICTING INFORMATION IN
TESTOSTERONE AS ESTROGEN.
WITH HORMONE REPLACEMENT
THERAPY THERE ARE SUGGESTIONS
IT CONTRIBUTES TO HEART
DISEASE OR HELPS PREVENT HEART
DISEASE.

Beth says THE USE OF HORMONE
REPLACEMENT THERAPY IN
WOMEN -- WE WILL STICK TO
WOMEN BECAUSE WE WERE TALKING
ABOUT TESTOSTERONE A MINUTE
AGO -- IS STILL HIGHLY
CONTENTIOUS.
THERE IS SOME EVIDENCE IN A
RECENT TRIAL THAT IF YOU
ALREADY HAVE HEART DISEASE AND
A WOMAN WITH HEART DISEASE,
ADDING ESTROGEN ADDS NO
BENEFIT OVER FOUR YEARS.
WE WORRY ABOUT THE DEVELOPMENT
OF BLOOD CLOTS AS ANY
ESTROGEN.
ONE OF YOUR COLOURS CALLED IN,
WOMEN IN PREGNANCY HAVE HIGH
LEVELS OF ESTROGEN AND THEY
ARE AT HIGH RES BEING OF BLOOD
CLOTS IN THE LEGS.
NO BENEFIT IN THE WOMAN WHO
HAS HEART DISEASE IF SHE'S ON
THE RIGHT DRUGS.
THE ASPIRIN, BETA BLOCKERS,
ACE INHIBITORS OR HAVE YOUR
SURGERY OR ACIO PLASTY, YOU
SHOULD HAVE IT.
THE INCREMENTAL ESTROGEN WILL
HAVE IN THE SHORT TERM, FOUR
OR FIVE YEARS, IN ADDITION TO
THE GREAT MEDICATIONS WE HAVE
AVAILABLE TO US IS PROBABLY
VERY LOW.
WE KNOW THERE'S NO ADDED
BENEFIT.
LONG-TERM EFFECTS OF ESTROGEN.
STILL DON'T HAVE THE ANSWER.
DIFFERENT TYPES OF ESTROGEN,
DON'T HAVE THE ANSWER.
WE HAVE AN ONGOING STUDY
LOOKING AT THE NEWER COUSIN OF
ESTROGEN NOW.
ONGOING RESEARCH.
IN WOMEN WHO HAVE NOT GOT
HEART DISEASE, WHO MAY HAVE
SOME RISK FOR HEART DISEASE,
THE EVIDENCE IS CONFLICTING,
BUT THERE MAY BE A BENEFIT.
THERE'S FAIR EVIDENCE THAT
SUGGESTS THE LONG-TERM
BENEFITS MAY OUTWEIGH THE
RISKS OF ESTROGEN.
TAKING ESTROGEN IS AN
INDIVIDUAL DECISION A WOMAN
MUST TAKE WITH HER PHYSICIAN.
THERE ARE RISKS AND HAVE TO BE
WEIGHED WITH BENEFITS.

Karen says THERE ARE VOLUMES OF
RESEARCH THAT CAN OVERWHELM
WHEN A WOMAN IS ON HORMONE
REPLACEMENT THERAPY.
THE CONTROVERSY OF BREAST
CANCER OR CONTRIBUTING TO THE
RISK OF CANCER.
YOU REALLY HAVE TO MAKE A
DECISION WITH YOUR PHYSICIAN
ABOUT IT.

Beth says YOU ALSO DON'T HAVE TO BE
AFRAID OF ESTROGEN OR AFRAID
OF PROTECTING YOUR HEART.

Karen says MENOPAUSAL WOMEN, THERE ARE
A LOT THAT LOVE IT.

Beth continues I WILL SAY OVERALL I THINK
ESTROGEN CAN HELP THE HEART.
THE QUESTION IS THE BALANCE OF
ESTROGEN, WHICH TYPE OF
ESTROGEN, WHICH PERSON TO GIVE
IT TO.
THERE IS A DEFINITE -- IT'S A
SLIGHTLY INCREASED RISK OF
BREAST CANCER IN THE LONG
TERM.
YOUR RISK OF HEART DISEASE AND
BENEFIT IN REDUCING THE RISK
OF HEART DISEASE MAY OUTWEIGH
THE INCREASE RISK OF BREAST
CANCER.
THAT'S SOMETHING A WOMAN HAS
TO TALK TO HER DOCTOR ABOUT.

Karen says THAT PATCH HAS CHANGED MANY
WOMEN'S LIVES.

Beth says THERE ARE NO GOOD LONG-TERM
CARDIAC OR HEART STUDIES WITH
THAT PATCH.
THAT'S AN AREA WE HAVE TO LOOK
INTO.

Karen says GO TO SUZANNA CALLING FROM
PETERBOROUGH.

Susanna says HI.
WHEN I WAS 39 YEARS OLD, I HAD
MY FIRST HEART ATTACK AND AT
THE TIME WAS DIAGNOSED WITH --
I RESEARCHED ON THE INTERNET.
I'VE WRITTEN LETTERS TO
RESEARCH AND DEVELOPMENT
COMPANIES.
MY DOCTORS HAVE TAKEN MUCH
CARE WITH ME AS THEY CAN.
BUT I CAN'T GET VERY MUCH
INFORMATION ABOUT IT.
AND I'M NOW 44 AND A CARDIAC
CRIPPLE.
I WOULD JUST LIKE INFORMATION
ON THAT SYNDROME.

Karen says ARE YOU FAMILIAR WITH THE
SYNDROME?

Beth says YES.
NOW, AGAIN, OVER THE PHONE
THAT IS A SYNDROME THAT PEOPLE
GET LABELLED WITH THAT MAY OR
MAY NOT BE THE TRUE SYNDROME.
PRINCE MEDDLES ANGINA IS WHERE
THE ARTERY DOESN'T HAVE A
NARROWING, BUT THE ARTERY GOES
INTO A SPASM.
WE SEE THAT IN CARDIOLOGY WITH
VERY DEFINITE CHANGES IN THE
CARDIOGRAM.
THERE ARE PEOPLE OUT THERE WHO
GET THE LABEL WITHOUT HAVING
THOSE DEFINITE CHANGES.
SO WE CAN SEE PEOPLE, AND IT'S
RARE, THAT PEOPLE HAVE HEART
ATTACKS WITH NORMAL CORONARY
ARTERIES.
IN FACT, PEOPLE WHO HAVE HEART
ATTACKS HAVE A VERY GOOD
OUTLOOK.
IT'S RARE.
THE ACTUAL DIAGNOSIS IS ONE
THAT REALLY NEEDS TO BE MADE
FIRMLY.
AND I ENCOURAGE OUR CALLER, AS
SHE HAS, IT SOUNDS LIKE, TO
MAKE SURE SHE'S BEEN SEEN BY A
GOOD CARDIOLOGIST.
MAKE SURE THAT'S THE TRUE
DIAGNOSIS AND NOT JUST SOMEONE
WITH CHEST PAIN SIPD TROM BUT
NO PROBLEM OF BLOOD FLOW TO
THE HEART.
IF THAT'S THE CASE, AND IT'S A
MISDIAGNOSIS, I SUGGEST THERE
ARE ONGOING STUDIES AND
RESEARCH AS TO WHY PEOPLE
DEVELOP CHEST DISCOMFORT BUT
HAVE NORMAL CORONARY ARTERIES
AND DON'T HAVE A TRUE PROBLEM
WITH THE HEART.
THERE ARE A LOT OF LIFESTYLE
CHANGES ONE CAN MAKE TO FEEL
BETTER.

Karen says LOTS OF PEOPLE ARE
RESEARCHING THE 'NET.

Beth says I WOULD SUGGEST THE CALLER
HOOK UP TO THE HEART AND
STROKE FOUNDATION WEBSITE AND
GO FROM THERE.
AGAIN, OUR St. MIKE'S SITE HAS
LINKS TO OTHER CREDIBLE
WEBSITES FROM THE CANADIAN
SIDE AND THE AMERICAN SIDE IN
TERMS OF CREDIBLE HEART HEALTH
INFORMATION.

Karen says WE WILL HAVE THE ADDRESSES
AT THE END OF THE SHOW.
IT'S INDICATIVE HOW PEOPLE ARE
TAKING CONTROL OF THEIR LIFE.
I THINK IT'S FABULOUS WE
BECOME A PART OF OUR HEALTH
CARE AS OPPOSED TO JUST
SAYING -- WITH ALL DUE RESPECT,
YOU'RE THE EXPERT AND YOU TELL
ME WHAT I NEED TO DO.

Beth says I CAN'T TELL YOU WHAT TO DO
UNLESS I HAVE A FULL FEEL FOR
THINGS.
THERE IS NO DOUBT THAT
PATIENTS ARE BECOMING MORE
PROACTIVE.
WE ENCOURAGE THAT.
THE HEART AND STROKE
FOUNDATION HAS A WHOLE
CAMPAIGN FOR PATIENTS WITH
HEART DISEASE.
IT'S CALLED KNOW YOUR NUMBERS.
KNOW YOUR CHOLESTEROL.
IF YOU HAVE HEART DISEASE OUT
THERE AND YOU'RE LISTENING AND
TAKING A SILENT POLL OUT THERE,
THE MAJORITY OF PATIENTS DON'T
KNOW THE LEVEL OF GOOD
CHOLESTEROL OR BAD CHOLESTEROL
ARE OR SHOULD BE.
KNOW YOUR BLOOD PRESSURE.
WHAT NORMAL BLOOD
PRESSURE IS FOR YOU.

Karen says THE HEART AND STROKE
FOUNDATION, WE WERE TALKING TO
THEM ABOUT IT, SAID YOU SHOULD
KNOW YOUR NUMBERS LIKE YOU
KNOW YOUR HAIR COLOUR AND YOUR
BLOOD TYPE.
THERE'S VERY -- OR YOUR PHONE
NUMBER.
VERY FEW PEOPLE WOULD EVEN
KNOW WHAT A GOOD PRESSURE RATE
IS.
THIS IS AN IDEA -- THEN YOU
HAVE TO TALK TO YOUR DOCTOR
MORE ABOUT IT.

Beth says I ENCOURAGE PEOPLE TO GO TO
THEIR FAMILY DOCTOR AND GET A
HEART HEALTH CHECK, GET YOUR
RISK FACTORS CHECKED.
THAT MAY NOT MEAN DRAWING
BLOOD.
IT COULD BE DOING A HISTORY
AND PHYSICAL AND ASKING, DOC,
WHAT SHOULD MY BLOOD PRESSURE
BE, WHAT ARE MY RISKS.

Karen says WHAT ARE MY NUMBERS.
MARY'S NEXT CALLING FROM GRAND
BEND.
HI, MARY.

Mary says I WANDERED IF DOCTOR BETH
COULD TELL ME, MY HUSBAND HAS
ANGINA AND HE HAS TO GO FOR A
KNEW CLEAR MEDICINE TEST NEXT
WEEK, A PROFUSION STUDY OR
SOMETHING.
CAN YOU EXPLAIN WHAT THAT IS?

Beth says I WILL EXPLAIN IN GENERAL.
IT'S WORTHWHILE TO UNDERSTAND
WHEN PEOPLE HAVE CHEST PAIN OR
ANGINA LIKE YOUR HUSBAND HAS,
THERE'S ALL SORTS OF TESTS WE
HAVE IN CARDIOLOGY TO SORT OUT
IF IT IS THE HEART OR NOT, AND
THEN WHAT IS YOUR RISK OF
HEART DISEASE.
WHAT CATEGORY DO YOU BEST FIT
INTO IN TERMS OF TREATMENT.
SHOULD WE CONTINUE WITH
MEDICATIONS.
SHOULD A PATIENT IN GENERAL,
NOT TALKING ABOUT YOUR HUSBAND,
NEED BYPASS BECAUSE HE OR SHE
IS AT HIGHER RISK.
AND ONE OF THE WAYS WE SORT
THAT OUT IS BY STRESSING
PEOPLE SO WE GET PEOPLE ON THE
TREADMILL.
SOMETIMES WE SIMULATE EXERCISE
BY INJECTING SOMETHING THAT
CAUSES THE HEART TO BE
STRESSED, AND THEN LOOK AT THE
BLOOD FLOW TO THE HEART.
IF THERE'S A NARROWING OR
BLOCKAGE THERE, THE BLOOD FLOW
WILL BE LESS DURING THE SCAN.
THAT PROFUSION SCAN, PROFUSION
MEANING BLOOD FLOW, IS LOOKING
AT THE BLOOD FLOW TO THE
HEART.
IT'S A COMMONLY USED
DIAGNOSTIC TOOL.
IT'S A COMMONLY USED TEST.
IT'S A VERY HELPFUL TEST
SORTING OUT SOMEONE'S
DIAGNOSIS AND PROGNOSIS, HOW
WELL THEY WILL DO.

Karen says A SCARY TIME KNOWING YOU
HAVE WITH YOUR HUSBAND GOING
IN FOR THOSE TESTS.
YOU AS A WOMAN YOURSELF ARE
WAITING FOR TESTS OR JUST TO
GET INTO SUNNYBROOK OR SOME OF
THE SPECIAL HOSPITALS, MY
GIRLFRIEND WENT THROUGH THIS
WITH HER MOTHER, SHE FLEW IN
FROM VANCOUVER.
THE CRISIS THAT ALL OF A
SUDDEN ENSUES AROUND A FAMILY
WHERE YOU WANT TO KNOW THE
OUTCOME, IS IT A HEALTHY
HEART.
IF THERE IS BLOCKAGE, WHAT'S
GOING TO HAVE TO BE DONE.

Beth says IT'S A VERY, VERY
NERVE-RACKING TIME.
THE QUESTION AFTER DIAGNOSIS
OF HEART DISEASE OR PATIENTS
WITH HEART DISEASE.
TO AVOID AND TRY TO REDUCE
SOMEONE'S STRESS, KNOWLEDGE IS
A GOOD THING.
I ENCOURAGE PATIENTS AND
FAMILY MEMBERS TO ASK
QUESTIONS.
NOT EVERY WOMAN WHO COMES WITH
CHEST PAIN ENDS UP WITH HEART
DISEASE.
SOMETIMES THEY DON'T NEED A
TEST, JUST A PROPER HISTORY.
THERE ARE MANY PATIENTS WHO
HAVE CORONARY ARTERY DISEASE
AND TALKING ABOUT IT BEING THE
LEADING CAUSE OF DEATH IN
CANADIAN WOMEN AND MEN,
CANADIANS IN GENERAL.
SO THERE'S A FEAR FACTOR
THERE.
YOU JUST NEED TO HAVE
COMMUNICATION, HOPEFULLY
SUPPORTS IN YOUR OWN LOCAL
ENVIRONMENT.
FOR EXAMPLE, VARIOUS REHAB AND
PREVENTION CENTRES ACROSS THE
PROVINCE HAVE SUPPORTS BE IT
WITH PLACES TO CALL OR
INFORMATION, LINK UP WITH
WEBSITES.
MORE UNDERSTANDING THE PATIENT
AND FAMILY HAS.
FAMILIES PLAY A VERY IMPORTANT
ROLE.

Karen says AND NOT TO HAVE IT HAPPEN
TO A FAMILY MEMBER BEFORE
EVERYONE STARTS SAYING -- MY
GIRLFRIEND SAID, YOU HAVE TO
KNOW WHAT YOUR CHOLESTEROL
NUMBERS ARE.
SHE'S TERRIFIED WHEN HER
MOTHER STARTED GETTING
SHORTNESS OF BREATH WHILE THEY
WERE WALKING.
WE HAVE TO TAKE BETTER CONTROL
OF OUR HEALTH.
SHE DIDN'T FEEL THAT WAY UNTIL
IT HAPPENED TO SOMEONE IN YOUR
FAMILY.
YOU DON'T WANT IT TO COME TO
THAT.

Beth says IT'S NOT EVERYONE NEEDS
THEIR CHOLESTEROL CHECKED.
EVERYONE HAS TO BE AWARE THAT
HEART DISEASE IS THE MAIN
THREAT DOWN THE ROAD AND WHAT
THE RISK FACTORS ARE, KNOW
YOUR NUMBERS, AND MAKE SURE
YOU LEAD A HEART HEALTHY LIFE
OR START TO LEAD A HEART
HEALTHY LIFE.

Karen says WE TALK HEART DISEASE.
HI, JENNY.

Jenny says I WONDER IF IT'S A
MYTH THAT ALCOHOL HELPS WITH
THE HEART OR IF IT'S ONLY RED
WINE OR IF WHITE WINE WOULD
HELP.
IS THAT TRUE OR JUST A MYTH?

Karen says I'M GLAD YOU BROUGHT THAT
UP.
WE HAVEN'T TOUCHED ON THAT
YET.
I THINK WITH SOME OF THESE
SUGGESTIONS, DRINK A BOTTLE OF
RED A DAY.

Beth says IT'S A GOOD QUESTION.
ALCOHOL AND THE HEART.
THE HEART AND STROKE
FOUNDATION HAS CLEAR
RECOMMENDATIONS THAT ONE
SHOULD NOT BE DRINKING EXCESS
ALCOHOL.
THERE IS SOME CONFLICTING
EVIDENCE THAT A GLASS OF RED
WINE A DAY IS GOOD FOR THE
HEART.
WE KNOW, HOWEVER, IF YOU DRINK
ALCOHOL IN EXCESS, THERE ARE
DETRIMENTAL EFFECTS ON THE
HEART.
THERE ARE DETRIMENTAL EFFECTS
ON YOUR BLOOD FATS AND WEIGHT.
DRINKING A GLASS OF WINE A DAY
IS ALMOST AS MANY CAMRYS AS
EATING A CHOCOLATE BAR A DAY.
NO ONE SHOULD BE DOING THAT
ROUTINELY.
WE DON'T ENCOURAGE STARTING TO
DRINK A GLASS OF RED WINE A
DAY BECAUSE THERE IS SOME
EVIDENCE OUT THERE ABOUT THE
ANTIOXIDANTS IN RED WINE.
IF YOU DRINK WINE, DRINK RED
INSTEAD OF WHITE.
CUT DOWN THE OVERALL ALCOHOL
INTAKE.
ALCOHOL IS ACTUALLY A POISON
IN THE HEART.
WE HAD A CALL TALK ABOUT A
WEAKENED HEART MUSCLE.
ONE FORM OF THIS IS CAUSED BY
INCREASED ALCOHOL INTAKE.
WE HAVE TO BE CAREFUL.

Karen says I IMAGINE CARDIOLOGISTS
WITH STUDIES THAT HAVE BEEN
OUT FOR SEVERAL YEARS NOW
PROBABLY BALK AT THE THOUGHT
THAT EVERYONE WILL START
DRINKING TOO MUCH.
ONE COULD BE HELPFUL BUT FOUR
A DAY REGULARLY COULD DO
DAMAGE.

Beth says THAT'S RIGHT.
THERE'S ALSO THE FRENCH
PARADOX.
A LOT OF THIS STARTED UP
BECAUSE THEY THOUGHT PEOPLE
DIED LESS OFTEN OF HEART
DISEASE IN FRANCE.
WE KNOW IF THEY DIE SUDDENLY,
THEY DON'T COUNT THAT AS
CARDIAC.
SO WE DON'T HAVE ALL THE
ANSWERS OUT THERE.

Karen says I HEAR THAT ALL THE TIME
ABOUT HEALTH RATES IN FRANCE.
THEY DRINK A LOT OF WINE.
DONALD FROM STAY NOR.
HI, DONALD.

Donald says I HAD QUADRUPLE
BYPASS SURGERY ABOUT TEN YEARS
AGO.
HE SAID IT WOULD BE GOOD FOR
ABOUT TEN YEARS.
AND NOW I'M STARTING TO FEEL
MORE CHEST PAINS AND HAVING TO
REDUCE MY ACTIVITIES.
I WAS WONDERING WHAT OPTIONS
ARE OPEN TO ME NOW IN TERMS OF
MORE SURGERY OR WHATEVER.

Beth says SO IN GENERAL, DONALD'S A
PATIENT WHO HAS HEART DISEASE
AND HAS HAD BYPASS.
ALL OF THE TREATMENTS WE HAVE
AVAILABLE TO US AREN'T REALLY
CURES.
YOU BYPASS THE BLOCKAGE.
THE PROCESS IS ONGOING.
IT'S AN IMPORTANT ISSUE.
IN GENERAL, ANYBODY WHO'S HAD
BYPASS SURGERY AND IS HAVING
MORE ANGINA TEN YEARS OUT
NEEDS TO SEE YOUR
CARDIOLOGIST.
YOU HAVE TO BE REFERRED ON TO
A CARDIOLOGIST FOR VARIOUS
INVESTIGATIONS.
MAYBE THAT NUCLEAR SCAN, MAYBE
OTHER TESTS, MAYBE JUST A GOOD
HISTORY AND PHYSICAL.
YOU NEED TO GO TO A DOCTOR AND
MAKE SURE YOU GET SEEN BY A
CARDIOLOGIST IF YOU'RE TEN
YEARS OUT.
OPTIONS VARY.
BUT I ALSO CAN TELL YOU IF
YOU'VE HAD BYPASS SURGERY TEN
YEARS AGO, YOU SHOULD BE ON
GOOD PREVENTIVE MEDICINES.
SEE IF YOU NEED A CHOLESTEROL
LOWERING MEDICATION, ASPIRIN.
A NEW DRUG, ASK YOUR DOCTOR
BUT A NEW CLASS OF DRUGS --
NOT NEW BUT SHOWN TO BE VERY
EFFECTIVE ARE A GROUP OF DRUGS
CALLED ACE INHIBITORS AND BETA
BLOCKERS.
SPEAK TO YOUR DOCTOR.
IF YOU'RE HAVING MORE CHEST
DISCOMFORT AND TEN YEARS OUT
AFTER BYPASS, YOU HAVE TO SEE
YOUR CARDIOLOGIST.

Karen says CUTTING EDGE RESEARCH,
GROWING NEW BLOOD VESSELS.
SOMETHING YOU LOOK FORWARD TO
DOWN THE ROAD.
WHAT'S THE STATUS OF THAT?

Beth says IT'S UNDER INVESTIGATION.
ONGOING TRIALS ARE CURRENTLY
HAPPENING AT SAINT MICHAEL'S.
IT'S THE FIRST IN CANADA.

Karen asks ARE WE TALKING ABOUT
SYNTHETIC BLOOD?

Beth replies WHAT WE'RE TALKING ABOUT IN
SOME PEOPLE AFTER THEY HAVE
BYPASS SURGERY OR EVEN WITHOUT
BYPASS SURGERY, THE NARROWING
IN THE BLOOS VESSELS ARE TOO
NARROW TO PUT A BYPASS IN OR
GO IN AND HAVE A REDO BYPASS.
NO EVERYONE IS A CANDIDATE FOR
BYPASS.
SOMETIMES THE BLOOD VESSELS
ARE TOO SMALL OR TOO BLOCKED.
THEY PUT IN THE PATIENT'S
HEART GENES THAT PROMOTE THE
GROWTH OF NEW BLOOD VESSELS.
IT'S VERY EXPERIMENTAL BUT
VERY EXCITING AND DOING
CLINICAL TRIALS NOW.

Karen says WHO WOULD BE A GOOD
CANDIDATE FOR THAT?

Beth says I THINK BY AND LARGE
PATIENTS REFERRED BY THEIR
CARDIOLOGIST WHO HAVE BEEN
TOLD THAT THEY'RE NOT GOOD
CANDIDATES FOR BYPASS SURGERY
EITHER FIRST TIME OR REDO, ARE
HAVING SYMPTOMS AND THE NO
OPTION PATIENTS.
WE USUALLY HAVE TRICKS UP OUR
SLEEVE IN TERMS OF INGESTING
MEDICATIONS.
IT'S VERY EXCITING WITH MY
COLLEAGUES IN MY OWN HOME
HOSPITAL OF St. MICHAEL'S.

Karen says GO TO CAROL WHO HAS A
QUESTION FOR US HERE IN
TORONTO.

Carol says HELLO.
I WANTED TO ASK THE DOCTOR
ABOUT HOMOCYSTEINE LEVELS.
I HEARD SOME PEOPLE SAY THAT'S
A BETTER PREDICTOR IF YOU HAVE
HEART DISEASE.
COULD YOU DISCUSS IF THESE
TESTS SHOULD BE DONE AND WHAT
THE FINDINGS HAVE BEEN?
THANK YOU.

Beth says HOMOCYSTEINE.
GREAT QUESTION.
IT IS AN ENZYME IN THE BLOOD
THAT IS AFFECTED -- IT'S
COMPLICATED TO EXPLAIN, BUT
LET ME TAKE A STEP BACK AND
SAY IT'S A RISK FACTOR FOR
HEART DISEASE.
IT IS ASSOCIATED -- HIGHER
LEVELS OF HOMOCYSTEINE IN THE
BLOOD ARE ASSOCIATED WITH
HEART DISEASE.
WE DON'T KNOW IF IT CAUSES
HEART DISEASE THE WAY
CHOLESTEROL HAS.
CHOLESTEROL HAS BEEN SHOWN TO
CAUSE OR INFLUENCE THE
PROGRESSION OF HEART DISEASE.
THE CURRENT RECOMMENDATIONS
ARE NOT TO SCREEN FOR
HOMOCYSTEINE IN SOMEBODY WHO
YOU'RE WORRIED ABOUT.
FOR ME THEY'RE HAVING HEART
DISEASE OR AT RISK FOR HEART
DISEASE.
THE TREATMENT FOR HIGH
HOMOCYSTEINE LEVELS IS TO EAT
PROPERLY, B-VITAMINS.
EATING A GREEN, LEAFY DIET AND
APPROPRIATE VEGETABLES IN YOUR
DIET, YOU HAVE LOWER LEVELS OF
HOMOCYSTEINE IN GENERAL.
I DO NOT AND WE DO NOT AT THE
CARDIAC PREVENTION ROUTINELY
SCREEN PATIENTS FOR
HOMOCYSTEINE.
THE TEST IS NOT COVERED BY
OHIP ROUTINELY BECAUSE IT IS
AN ASSOCIATEION.
THERE WILL BE A LOT MORE
RESEARCH IN THE NEXT FIVE TO
TEN YEARS ON HOMOCYSTEINE.
THE POPULATION SHOULD NOT GO
OUT AND GET HOMOCYSTEINE
CHECKED.
THERE IS THE ODD, VERY YOUNG
PERSON WITH SEVERE HEART
DISEASE THAT HAS NO OTHER RISK
FACTORS THAT WE MAY OPT TO
LOOK AT THE HOMOCYSTEINE IN.

Karen says I'M THINKING OF OUR FIRST
CALLER WHO WAS TALKING ABOUT
HER MOM WITH HEART DISEASE AND
SHE WAS 50 POUNDS OVERWEIGHT
AND SMOKING.
YOU WERE TALKING SO MUCH ABOUT
DIET.
HOW WOULD SOMEONE IN THAT
SITUATION MAKE A LIFE CHANGE?
I KNOW THAT YOU'RE HERE TO
PROMOTE WHAT WE SHOULD BE
DOING RIGHT.
IT CAN BE VERY DIFFICULT TO
HAVE A SEDIN TARRY LIFE AND
TURN OVER THIS NEW LEAF AND
ALL OF A SUDDEN BECOME
HEALTHY.
IT'S SO HARD TO TAKE THE FIRST
STEPS.

Beth says IF YOU HAVE RISK FOR HEART
DISEASE, YOU HAVE TO TACKLE
ONE AT A TIME.

Karen says LIKE QUITTING SMOKING.

Beth says I WAS GOING TO SUGGEST TO
YOU THE MOST IMPORTANT RISK
AND -- THE TREATABLE CAUSE OR
RISK FACTOR FOR HEART DISEASE
IS SMOKING, BECAUSE IT CAUSES
THE HIGHEST AMOUNT OF RISK FOR
SOMEBODY.
YOU CAN'T CHANGE YOUR PARENTS,
YOU HAVE A FAMILY HISTORY.
IF YOU CHECK ONE RISK FACTOR
TO MODIFY, GRADUALLY WITH TIME
PEOPLE CAN MODIFY MORE THAN
ONE, IT'S SMOKING.
QUITTING SMOKING IS ONE OF THE
MOST IMPORTANT THINGS THAT A
PERSON CAN DO FOR THEIR LIFE
AND OVERALL REDUCTION IN
DEATH.
THE OTHER THING AND WOMEN
WORRY ABOUT SMOKING AND
GAINING WEIGHT.
YOU MAY GAIN A FEW POUNDS WHEN
YOU QUIT SMOKING.
THERE'S THE MYTH OUT THERE
ABOUT LOOKING HEALTHY AS
OPPOSED TO BEING HEALTHY.
I DON'T CARE IF MY PATIENTS
ARE SLIGHTLY OVERWEIGHT AND
WALKING AND NOT SMOKING.
THEY'RE HEALTHY ON THE INSIDE.
THEY MAY NOT BE SKINNY LIKE A
FASHION MODEL WHO'S PROBABLY
NOT SO HEALTHY ON THE INSIDE,
THAT THE THIN PERSON IS THE
HEALTHY PERSON.
IF YOU'RE THIN AND SMOKING AND
NOT ACTIVE, YOU'RE NOT HEALTHY
ON THE INSIDE.
YOU CAN BE FIVE, TEN, FIFTEEN
POUNDS OVERWEIGHT, LEADING A
HEART HEALTHY LIFE AND DOING
THE RIGHT THINGS TO REDUCE THE
RISK FOR HEART DISEASE.
I WILL BRING UP SOMETHING IN
TERMS OF THE HEART AND STROKE
FOUNDATION OF CANADA.
WE HAVE -- THERE'S A WOMAN'S
HEART SMART GUIDE.

Beth shows a pink and white guide that reads “Heart Smart Women.”

Beth continues YOU CAN GET THOSE BY CALLING
THE HEART AND STROKE
FOUNDATION FOR WOMEN BUT MEN
AS WELL.
I WILL UP UP THE GUIDE AND
SUGGEST TO YOU THAT THERE ARE
WAYS TO REDUCE STRESS IN THIS
GUIDE, FAT FACTS SO WE CAN
TALK ABOUT DIET.
THERE'S ALL SORTS OF THINGS
THAT WOMEN AS WELL AS MEN CAN
LOOK AT IN TERMS OF PREVENTION
OF HEART DISEASE.
IT HAS TIPS ON SHOPPING IN
TERMS OF YOUR CHOLESTEROL AND
EATING A HEART HEALTHY DIET.
WHEN SOMEONE ASKS WHERE DO YOU
BEGIN, STOP SMOKING.
AND THE REST WILL HOPEFULLY
COME INTO PLACE WITH SOME
SENSIBLE ADVICE FROM
ORGANIZATIONS LIKE THE HEART
AND STROKE FOUNDATION.
GO TO YOUR FAMILY DOCTOR AND
GET HANDOUTS AND ADVICE ON
LEADING A HEART HEALTHY
LIFESTYLE.

Karen says WE WILL BE ABLE TO GET
INFORMATION ON THAT FROM THE
WEBSITE.
THANKS SO MUCH FOR COMING IN,
BETH.
LOTS OF GREAT INFORMATION.
ENJOYED IT VERY MUCH.
THANKS.

Beth says MY PLEASURE.

Karen says DOCTOR BETH ABRAMSON A
RESEARCHER WITH THE HEART AND
STROKE FOUNDATION.
YOU WANT MORE INFORMATION ON
THE HEART AND STROKE
FOUNDATION WEBSITE HERE IT IS.

A slate pops up that reads “Heart and Stroke. 1-888-HSF-INFO. 188-473-4636. www.hsf.on.ca. Saint Mike’s www.smh.toronto.on.ca.”

Karen concludes THAT’S IT FOR TODAY’S SHOW.
WATCH MORE ON LIVE
MONDAY
TO FRIDAY STARTING AT
1 O’CLOCK ON TVO.

The slate changes to “The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances.”

Watch: Women And Heart Disease