The heart of the matter

Most people are unaware that heart disease is the Number 1 killer of women

Sarah and Alex Fields and their children (names withheld by request). Photo Courtesy JHarris Photography

The last thing Sarah Fields expected was to be a patient at the University of Ottawa Heart Institute.

Fields had always been an active person. The 30-year-old mother of two skated, skied, played basketball and ultimate frisbee. “I ate well, or so I thought, and was always a healthy weight,” she says. None of that mattered. During her first pregnancy, she was diagnosed with hypertension (high blood pressure). “Around my 30th week, my obstetrician put me on modified bed rest,” says Fields. “I had to take medical leave from my teaching job. I was in and out of the hospital every three or four days. I had to buy a blood pressure monitor and I was very tired.”

Sarah Fields and her child (name withheld by request). Photo Courtesy JHarris Photography

Fields found out that when her mother was pregnant with her brother, she had high blood pressure, so there was family history. Six months after her son was born, her doctor suggested she’d be a good candidate for the CardioPrevent® Program at the Heart Institute. “I was a little reluctant at first—I’m 30 years old—but going through the program was the best thing that ever happened to me.”  Fields was paired with health coach Nadine Elias who helped her set goals.

“It was an eye opener,” says Fields. “So many of the things I thought I was doing right were actually affecting my health.” She learned about portion size, healthy eating around the holidays and how important exercise is. “There were lots of visuals and meeting one-on-one with Nadine was really helpful,” says Fields. “Then family and friends started telling me I looked amazing. And I’ve got way more energy now.” Fields had a second child 17 months ago. “Talk about night and day between my two pregnancies,” says Fields. “The day before my C-section, I was out shopping—I felt that great. And our whole family now has a healthier lifestyle. I’m thankful for the amazing care I received and the advice I got from Nadine. The scary part is that hypertension is so silent.”

Knowledge is key, says Elias, who works with the Prevention and Wellness Centre at the University of Ottawa Heart Institute. “Understanding your risk factors, including family history is the way of putting the puzzle together,” says Elias. “And everyone is different. The program looks at potential risk factors and ways to change to improve them and reduce the risk.” Many of the women who Elias sees may not even know they have risk factors. Hypertension is silent and needs to be measured regularly. “Pregnancy is often described as a ‘stress test’ that helps identify women who are at risk of developing chronic disease later in life,” says Elias. “We now know that such conditions carry serious implications for a woman’s long-term health.”  

Making lifestyle and habit changes can be a challenge, says Elias. But 80 percent of risk factors are changeable. “We work on why you have to make lifestyle changes and how to achieve that change,” says Elias. “We provide guidance, support, and knowledge so you can do it. We’re not here to tell a woman what to do—but to help build intrinsic motivation to do it.” She says Fields was an ideal candidate for the program. “She really got a scare with her first pregnancy,” says Elias. “And she didn’t want to go through that again, so she really took the program to heart.”

For Natalie Martin, program manager, CardioPrevent® Program, University of Ottawa Heart Institute, it’s about knowing your risk factors. “Most women are unaware that heart disease is the No. 1 killer of women,” says Martin. Pregnancy is really one long stress test for women, and it provides a window into potential risk factors for cardiovascular problems 10 to 12 years later. Martin stresses the importance of knowing your risk factors and knowing your own history as well. “Each woman is unique but markers like gestational diabetes, hypertension and pre-eclampsia can be indicators for issues later,” says Martin. “Thankfully most of these are caught by doctors and well identified during pregnancy. What our program provides is education and awareness. And our personalized approach helps women make those lifestyle changes, so it just becomes natural.” There is full risk-factor screening throughout the year-long CardioPrevent® program and all the information is sent to your own doctor for continued care. Your own family physician or obstetrician can make a referral to the program. “Just knowing your risk factors is so important,” says Martin. “Also know that those risk factors can show up as early as your second decade of life. And symptoms of heart disease for women can be quite vague, even for a couple of years. But also know that lifestyle changes—exercising, quitting smoking, a proper diet, and lower stress levels—can significantly lower your risk and keep your heart healthy.”   

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Useful websites

cwhhc.ottawaheart.ca/programs-and-services/postpartum-program

ottawaheart.ca/patients-visitors/tools-and-resources/cardiac-rehabilitation-top-10-tips

cwhhc.ottawaheart.ca/summit  

carp.ca

carp.ca/community/ottawa/