Guest: Dr Linda Worrall-Carter
Presenter: Wayne Bucklar
Guest Bio: Dr. Linda Worrall-Carter is CEO & Founder of Her Heart, a non-profit organisation that combines expert advice and information to increase awareness on the risks of heart disease in women. As a leading authority on Cardiovascular Health for Women, Linda has a background in nursing, teaching and research and has substantial leadership experience. Professionally, Linda has wide national and international networks and has been invited to work with a number of key national organisations including the Heart Foundation, NHMRC, and the ARC. In Australia, Linda has been recognised for her significant contribution to the Cardiovascular and Nursing Community and was awarded the CSANZ Cardiovascular Nursing Lecture as well as a Fellowship of the Cardiac Society of Australia and New Zealand.
Segment overview: In today’s Health Supplier Segment, we welcome Her Heart founder and CEO Dr. Linda Worrall-Carter who is here to discuss the not-for-profit organization’s objectives. Studies have shown that Every hour a woman in Australia dies of heart disease, so every day 24 lives will be lost. That’s one-in-three Australian women of all ages, and many of these deaths are often preventable. Today more than 90% of women in Australia have at least one risk factor for heart disease, and as many as 50% have two or more risk factors. Among Her Heart’s objectives is to raise awareness of the prevalence, risk factors and symptoms of heart disease in women.
Health Professional Radio
Wayne Bucklar: You’re listening to Health Professional Radio. My name is Wayne Bucklar and joining me today is Dr. Linda Worrall-Carter. Dr. Worrall-Carter is the founder and CEO of Her Heart. Welcome to the program Linda.
Dr. Linda Worrall-Carter: Thank you. And thank you for having me on the program Wayne, it’s wonderful.
Wayne: It’s our pleasure. Now Her Heart doesn’t absolutely lead me to understand what you do. So can you start by explaining what it is that you do and what geographical footprint you operate in?
Dr. Linda: Yes, yes absolutely and perhaps just to link it to my background too. So at the end of last year I decided after 15 years of doing research in the area of women and heart disease that perhaps we weren’t necessarily needing more research in this are, what we did need is “awareness.” So I decided to establish a not-for-profit and a charity which we called “Her Heart” which is dedicated to creating awareness around women and heart disease. And it’s interesting that you’ve talked about geographical footprint because actually we launched in June of this year and we anticipated having perhaps some widespread coverage around Australia, but what we didn’t realize that we would have so much interest worldwide. So thanks to google analytics, we’re now able to track where everybody’s coming on the website. We’ve actually had over 50 different countries within literally several weeks of launching and now we’ve had actually with just over 70 different countries access the website. And we’ve received some amazing feedback, it’s actually really great.
W: Linda why is there a particular difference between Her Heart and His Heart? Is there a research finding that supports this?
L: Yeah, that’s right. So I guess and as I mentioned having done a lot of extensive research in this area, there are distinct differences between men and women. And for many years we didn’t actually realize this so it wasn’t necessarily that women were purposely excluded from the research. But it was just generally thought that heart disease wasn’t an issue for women. So I’ve sort of looked at and try to pin it down to five reasons. And I think these five reasons to why this is happening for women and why in general the community don’t know that one in three women will die of heart disease.
W: So Linda if you’ve narrowed it down to five reasons, can you go through them for us?
L: Yes. One of the things that the first thing I think is in general this lack of awareness. So the first thing is that we can actually do some things about our risk factors, that we can’t do some things about the fact that we’re born with a family history. For example I have a family history of heart disease so there’s other things we can’t do such as change which is our age. We know that there’s an issue with women when we actually have, when we hit menopause so there’s not a lot we can do about that. And also there’s some links with different ethnicity, so which impacts some people from a … Thailand or an aboriginal background, so they’re also found to be at risk. However we can actually do a lot about other risk factors. We know that inactivity is a significant risk factor, because we’re talking now about sitting being the new smoking. So we can definitely have impacts on other things such as getting our lipids or our cholesterol within normal level, stopping smoking – this is the biggest thing that we can do to actually have a positive impact on our risk factor profile. And also we can keep things like our blood pressure and our diabetes under control. I guess with the risk factors, what people don’t know is that you actually only need one cardiac risk factor. So one cardiac risk factor needs to be elevated to have a significant impact on your cardiac profile. And when they’ve looked at women who have had heart attacks, 90% of them have actually only had one elevated risk factor. And many women in Australia, that’s up to 90% actually has more than one elevated risk factor so they actually have two or three risk factors.
W: Oh I see, and that’s got to push their profile right up.
L: That’s right. So the second thing I think it’s really important to know is that there is a difference in symptoms for men and women. And women don’t recognize the symptoms, they seem to think they’re going to get the same symptoms as men. So that is men typically get a lot of chest, they get chest pain going down and this radiates down their left arm, they feel very sweaty and it’s often comes on and fairly suddenly. Whereas women tend to feel shorter breaths, they’ll often feel very nauseated, their pain can still radiate through to their back up to their jaw even though they may have some central chest pain. So this difference in symptoms can be quite confusing to women. And also I think sometimes health professionals don’t take them up.
W: Yes, I didn’t realize it was such a difference in the way it presented it as a disease.
L: That’s right. And we know now that women also have differences in their coronary arteries, and I won’t go into it, called root of macrovascular disease. So this then precipitates women to sort of thinking well they don’t recognize the signs and symptoms so they’re not as easily able to ask for help. And I think that some of the work that we have done which I’ll talk about is how health professionals can also have a raised awareness around this. So it’s almost a sequential problem because women don’t recognize the symptoms and know the risk, they delay in getting treatment, though in women that we’ve interviewed for example will say “Well I wasn’t really sure. I started to phone a friend,” and really what they should be doing is dialing triple 0 and going to hospital. Some of the other things they will do is not prioritize themselves so they’ll say “Well I wasn’t really sure. I decided to make everything was organized at home. I had my mother to take to a hospital. I had this and I had that…” So they tend to put other people above themselves and really put themselves at risk because of this. So I think that one of the key things we need to look at is getting a real awareness so that women even if they’re not sure and they sort of feel a little bit embarrassed, literally you don’t want to die of embarrassment. And it’s critical that women get to hospital to be able to also get the required treatment. So over the last decade or so, I’ve also had some wonderful PhD students and one of them, my PhD student’s Dr. Lisa … who is an emergency nurse herself did some great research and found that the women weren’t allocated as higher risk call in the emergency department as men.
W: That’s an interesting finding too, isn’t it?
L: Yeah. So I think that one of the issues that we have is that health professionals, so what we don’t want to be doing is pointing the finger or blaming anyone or saying “Well women don’t know this and they don’t do that.” And GP’s don’t pick it up because that’s not helpful at all. And what we do want to do is highlight where the gaps are and where we can perhaps increase awareness and within our professional colleagues, one of the things is in the emergency department and we know that it isn’t just things specifically at one hospital because we bench mark the results. This bench mark, thii looked at the data across different hospitals around Victoria. And similarly women we’re given a lessen score than men. The offshoot of that is that obviously women are referred for less testing, so they’re less likely to receive the lifesaving treatments too.
W: Yes, I can see how that would all cascade together.
L: And I guess the fifth thing just quickly, is that this poorer outcomes in women. And they’re obviously this poorer outcomes because of that patient trajectory if you like.
L: You know what I mean, the statistic, taking longer to have treatment. And heart attack in women is actually more fatal than men. So they’re more likely to die in the following year, they’re more likely to get physiologically and psychological complication, heart failure. So it really is critical that we attend to these I guess misconceptions and look at increasing awareness.
W: And we hope today as a result of our chat, we’ll be able to help with some of those misconceptions. As I mentioned to you before the interview, most of our audience are clinicians in either acute care or some in aged care. So with a little bit of luck some of those today will be hearing you and going “Oh, maybe I or my patients fit that pattern. Maybe I should pay a little bit more attention now.” How do you people get in touch with you Linda?
L: So we’ve actually, I guess what I’d like to say in that and at what you have just said, it isn’t a bad news story. Because natural fact heart disease is 80% preventable. I think there’s nothing more depressing than to give a whole scenario of all the bad news, which I feel as if I’ve done. I mean the good news is when something’s 80% preventable, there’s so much to do. And what we are really wanting to do is significantly increase awareness around this. And you know look with different groups in this space because worldwide there is a campaign around the world which is called “Go Red For Women” which is sort of wearing a red dress on a national day, which this year in 2015 was June 11. There is a lot of advice we can give and we have established a range of different social media, we have a website which is www.herheart.org.au, we have Twitter. If you go to the website you can see all the different social media. We’ve got an Instagram page, we’ve got a very active Facebook page and I think that there’s the response we’ve had to the website and the social media has been phenomenal because it’s very easily digestible information that we’re giving out. We’re making it very consumer driven and so for example one of the things we’re all not getting enough obviously – sleep. Sleep has a profound effect on many aspects of your well-being including your heart. So there are several reasons to getting a good night sleep. So I think that people will relate to it on a personal level as well as a professional level.
W: Linda thank you for being with me today. It’s been a lovely to have a chat with you and your passion just comes bubbling out of you when you talk – it’s lovely to hear. I’ll mention that website again because I’m always getting in trouble for not giving enough warning about websites. It’s www.herheart.org.au and you can contact Dr. Linda Worrall-Carter there along with a range of information to support the issue of heart disease in women.
L: Yes. Well thank you very much for allowing me to showcase this work. It is critically important that we look at addressing this because we certainly need to be getting the message out there because there are so many mothers, wives, sister, daughters, dying unnecessarily. And it’s one of the top priority areas for nationally and internationally that needs addressing.
W: Well today we’ve done a little bit to help with that awareness. If you just missed my interview, it’s available on our website at www.hpr.fm as a transcript. It’s also available as an audio archive on SoundCloud and on YouTube. And you can access both of those from the Health Professional Radio website at www.hpr.fm. This is Wayne Bucklar for Health Professional Radio.