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poll shows canadians have misconceptions about heart attack, cardiac arrest and stroke

one in three canadians isn’t aware that cardiac arrest and heart attack are different.

by robin roberts
published oct 18, 2023
read time 8 minute read
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read time 8 minute read
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canadians have misconceptions about heart attack, cardiac arrest, stroke
one in three canadians isn’t aware that about 60 per cent of stroke victims are left with some level of disability. getty images
most of us have seen the classic images in the movies or on tv where the leading man, under severe stress, clutches his chest, grimaces in pain, and sinks dramatically to the floor, felled by a heart attack. according to the heart & stroke foundation of canada, that “hollywood heart attack” is as fictionalized as the film. mostly. but many of us believe that’s what a heart attack looks like. we also, according to the results of a new poll released today by the foundation, believe a lot of things about heart and stroke that have little basis in reality. and what we don’t know can hurt us.
among the misconceptions noted in the poll are:
  • one in three canadians isn’t aware that cardiac arrest and heart attack are different. cardiac arrest occurs when the heart suddenly stops beating; heart attack occurs when the blood flow to the heart is slowed or blocked.
  • one in three canadians isn’t aware that the signs of heart attack can be different between men and women. the most common is chest pain, but women can also experience a heart attack without chest pressure. they may feel pressure or pain in the lower chest, upper abdomen, or upper back, and extreme fatigue. as a result, half of women’s heart attacks go unrecognized.
  • one in three canadians doesn’t know that 90 per cent of people who suffer cardiac arrest when away from a hospital don’t survive. 
  • seven in 10 canadians don’t understand the risk factors for heart disease and stroke, believing the biggest risk is the result of family history. high blood pressure, in fact, is the number one risk factor for stroke and a major risk factor for heart disease.
  • more than four in 10 canadians believe heart failure means your heart suddenly stops when it really means it’s not functioning as it should be.
  • almost one in three canadians thinks driving someone suffering a stroke to the nearest hospital is better than waiting for an ambulance. in fact, they could be wasting valuable time because the nearest hospital might not be fully equipped to treat the stroke. paramedics are in constant communication with their dispatchers to be routed to the best hospital with a team of stroke professionals at the ready.
  • one in three canadians isn’t aware that about 60 per cent of stroke victims are left with some level of disability and 40 per cent have moderate to severe disability, both physical and mental.
  • one in three canadians believe it’s difficult to detect the signs of a stroke if you’re not a health-care professional, when anyone can learn the signs using the acronym fast: f stands for face, is it drooping? a is for arms, can they be raised? s is for speech, is it slurred or jumbled? t is for time — call 911 right away to head off major damage.

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what are we missing when it comes to heart disease and stroke?

although the death rate from heart disease and stroke has declined over the past 70 years since the heart & stroke foundation was formed, heart disease is still the second leading cause of death in canada behind cancer, according to the foundation. 
roughly 62,000 canadians have a stroke each year, one every 10 minutes, and more than 400,000 are living with the effects of a stroke every year, according to the vancouver stroke program at the vgh and ubc hospital foundation. 
and yet we still haven’t grasped the realities around the diseases and how they affect us personally. in fact, nine in 10 canadians have at least one risk factor, including high blood pressure, high cholesterol, diabetes, and irregular heart rhythm, caused by unhealthy diet and weight, lack of exercise, smoking, too much stress, alcohol or drugs. 
“one of the things that struck us [about the poll] is that the number of people who have direct contact with somebody who has a heart condition is going up,” says patrice lindsay, lead, engagement and stroke strategies at the heart & stroke foundation. 
“one out of every two canadians knows somebody who has had a heart attack, stroke or other related condition. but there’s this overall lack of awareness, which is obviously a big concern.”
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canadian society for exercise physiology
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lindsay says the foundation tracks and analyzes the data from these annual polls to look for patterns of change, and how they can best direct their awareness efforts. one area of continuing concern is the fact that women’s symptoms present differently but many health practitioners don’t recognize that. 
she says education needs to be stepped up all along the healthcare continuum so that when women seek help their symptoms are not brushed off. “it’s really training people to completely rethink, to make a complete paradigm shift so [practitioners are] thinking about women’s heart and brain first. women don’t always have that crushing hollywood chest pain.”
dr. sherryn rambihar, staff cardiologist at mackenzie health, and adjunct assistant professor in the division of cardiology, department of medicine at the university of toronto, says there’s ongoing research into male and female pattern heart disease that’s shedding more light. not all men have male pattern heart disease and not all women have female pattern, but some women have a different pattern. 
“typically, a heart attack is when a cholesterol blockage builds up in an artery and it ruptures,” says rambihar. “[it’s been said that] men explode, blocking the artery because of a cascade of inflammation that causes the heart muscle to not have enough oxygen. but a female pattern heart attack, instead of having that explosion, it may implode, and the heart artery may spasm. there are different categories of heart attacks but the diagnostic tools we have to treat and identify them are not there yet, which may lead to a treatment delay for women [and] who may be treated differently.”
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access is needed to treat heart disease and stroke

lindsay says certain communities, such as northern and remote areas, lack the access and equity to lifesaving treatment, and that’s not always rectified by throwing more money at the problem. 
“sometimes it’s not as much about money as changing the approach,” she says. “in some instances there are finances available but they’re not put in the right place. we need front-line programs that are easily accessible that reach people at their level rather than push them to go somewhere [else]. money, in some cases, [could be] better spent training community members who may not be health professionals, [but] can connect with [their community], be someone’s exercise buddy and help them with their exercises, for example. 
“there are some research studies right now looking at that. it’s really building capacity within, strengthening the community by giving them the tools to do it rather than trying to parachute health professionals in for bits of time.”
in addition to issues around universal access to health services and cost of medications, other barriers to good health outcomes include affordable housing, food and safe communities. 
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“in some areas, a fresh apple costs twice as much as a can of coke,” says lindsay. “you can’t blame people for that, that’s where they’re living and what they’re subjected to. so it’s really looking at food prices, access to safe spaces to go for a 20-minute vigorous walk every day.”
rambihar says part of the problem of relaying important health information is getting it to the people who need it. 
“we’ve made tremendous gains but i think [only] in certain communities,” she says. “and we’ve been able to get the message out, but to certain communities. [there are] people who, because of equity and access, may not be able to hear this message, or the message may not be getting to them.”
lindsay also points to statistics that show many people in ontario between the ages of 18 and 65 don’t have sufficient health coverage for, say, outpatient rehabilitation services after a stroke. 
“so if you have a stroke at a younger age, which we’re seeing more of due to workplace stressors, people have to dip into their retirement savings or use up all their savings to pay for private rehab or they go without. women who don’t have the same level of health and work benefits men do are really affected. people in casual or contract jobs, a lot of our front line workers, don’t have that same access to good benefits or the care they need.”
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prevention of heart disease and stroke is key

rambihar says 90 per cent of heart disease risk is preventable through lifestyle modifications, such as balanced diet, physical activity, managing blood pressure, sugars and cholesterol. but because of the awareness gap, poor lifestyle and lack of access can translate into heart disease or stroke. 
“everybody is touched by this because it can have a ripple effect to people in their communities.”
she says not only are some people at a disadvantage because of where they live in this huge country of ours, but other factors play a part. 
“some people, because of their sexual orientation, may feel uncomfortable accessing health care. some people, because of socioeconomic status, may not live in neighbourhoods where there is access to medical care in their language, or have culturally appropriate medical care they feel comfortable accessing. these are real issues for people that can ultimately lead to poor outcomes.”
she says even people who do live close to a hospital or clinic may not have the supports to access them. 
“i had a patient, a single mother, who decided to wait until her child went to school before she went to hospital with her heart attack because she didn’t have anyone to look after her child. another woman who is the primary caregiver for her spouse with parkinson’s had a heart rhythm problem that needed medical attention but she did not have anyone to stay at home with her husband. there are many reasons some people may not be able to access care that affect their heart and brain health and have consequences.”
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both lindsay and rambihar agree that putting power in the hands of the people will increase knowledge and decrease the incidences of heart attack and stroke and improve the outcomes for those affected. 
“we live in a country with infrastructure issues, sure, but if you have knowledge and awareness, then you have the ability to advocate for yourself, you can prevent [issues] before they happen,” says rambihar. “if you’re aware of your particular risk factors and signs of heart or brain disease when they happen, you can voice these issues and access health care as needed. 
“we have an amazing research and development industry with incredible technologies but if we can adopt strategies for treating stress and depression, managing blood pressure, cholesterol and blood sugars, it would lead to tremendous reduction in the issues we have.”
and give us all a much better hollywood ending.
robin roberts is a vancouver-based writer.
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