HEART HEALTH BY THE DECADE

Nearly two-thirds of all heart attacks and strokes occur in Canadians 65 or older, but younger Canadians are increasingly at risk. Here’s what you need to know at every age.

IN YOUR 20S & 30S YOUNG PEOPLE with heart-health issues are part of a growing minority. A study published in 2012 out of the University of Cincinnati College of Medicine found that, over a period of 12 years, strokes among people aged 20 to 54 made up an increasingly greater proportion of strokes across all age groups, growing from about 13 percent in 1993–94 to 19 percent in 2005.

Closer to home, the Heart and Stroke Foundation says several studies predict that the rate of strokes among younger adults will double in the next 15 years. The main reason? According to Dr. Tara Sedlak, a cardiologist at Vancouver General Hospital and clinical assistant professor at The University of British Columbia, it comes down to lifestyle—high stress levels, poor eating habits, lack of exercise and smoking. Research bears this out: The University of Cincinnati study suggested that a rise in lifestyle-related risk factors (such as diabetes, obesity and high cholesterol) may contribute to a higher incidence of stroke.

But there is a way to turn the tide: As with other age groups, simple changes such as exercising regularly, quitting smoking and eating healthily could see the rates of cardiovascular disease—and, more specifically, stroke—decrease, says Dr. Paula Harvey, director of the cardiovascular research program at Women’s College Hospital in Toronto. IN YOUR 40S & 50S CARDIOVASCULAR DISEASE is less common among younger women, in part because of their higher estrogen levels; the hormone offers some protection to the arteries. But as women approach menopause and their estrogen levels drop, the incidence of stroke and heart attack increases.

Unfortunately, broad knowledge of their increased risk may not protect perimenopausal women from misdiagnosis. According to research by the Canadian Medical Protective Association, which provides advice, legal assistance and risk-management education to 95,000 Canadian physicians, doctors are missing the signs of stroke in patients nearly 10 percent of the time, largely because symptoms are often nonspecific—patients often complained of headache, dizziness, nausea and vomiting.

And women, who have historically been less inclined to advocate for themselves, are particularly at risk. Research out of the University of Leeds in England showed that, between April 2004 and March 2013, 198,534 heart attack patients at National Health Service hospitals in England and Wales were initially misdiagnosed—and most of them were women. During that time, women suffering a heart attack were 50 percent more likely to be misdiagnosed compared to men.

It might be difficult to challenge doctors who tell you nothing’s wrong, but Dr. Sedlak encourages women to listen to their bodies and to be firm with health-care providers about what they’re experiencing. “If you feel there is a real problem, be persistent,” she says. IN YOUR 60S & BEYOND WOMEN OVER 65 have the most strokes of all age groups, but they still have fewer strokes than men the same age. However, a Danish study published in the Journal of the American Heart Association in 2015 found that, after 60, women tend to have more serious strokes than men—and they’re more likely to survive, which can have serious repercussions on quality of life.

John Sawdon, the public education and special projects director of the Cardiac Health Foundation of Canada, explains that cardiac rehabilitation programs, which are free with a referral from your doctor, are the perfect next step for recovering cardiac patients of all ages, but they’re particularly important for older Canadians, who tend to live more sedentary lives. These programs are supervised by a cardiologist and, after an assessment, are tailored by your cardiac rehab team, which usually includes nurses, physical therapists, kinesiologists and social workers. They can provide exercise training, education on heart-healthy living and stress counselling—all of which can contribute to the health and well-being of people who have heart problems. And they’re effective, too: “Research has shown that those completing cardiac rehab live seven years longer than control groups,” says Sawdon. It also “reduces incidence of another heart attack by 50 percent.”