WOMEN - Heart Foundation€¦ · In June 2019 the Heart Foundation, in collaboration with the...

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WOMEN & FORUM 19 JUNE 2019, SYDNEY HEART DISEASE Major supporters

Transcript of WOMEN - Heart Foundation€¦ · In June 2019 the Heart Foundation, in collaboration with the...

Page 1: WOMEN - Heart Foundation€¦ · In June 2019 the Heart Foundation, in collaboration with the George Institute for Global Health, held a one-day forum to showcase emerging research

WOMEN &

FORUM19 JUNE 2019, SYDNEY

HEART DISEASE

Major supporters

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WOMEN & HEART DISEASE FORUM 20192

© 2019 National Heart Foundation of Australia, ABN 98 008 419 761 (Heart Foundation)

Terms of use: This material has been developed for information and educational purposes only. It does not constitute medical advice.

Please consult your health care provider if you have, or suspect you have, a health problem. The information contained in this material has been independently researched and developed by the Heart Foundation and is based on the available scientific evidence at the time of writing. It is not an endorsement of any organisation, product or service.

The Heart Foundation and its employees do not accept any liability, including for any loss or damage, resulting from the reliance on the content, or in regards to its accuracy, currency and completeness. Any use of Heart Foundation material by another person or organisation is done at the user’s own risk.

This work, except as identified below, is licensed by the Heart Foundation under a Creative Commons Attribution – Non commercial – No Derivative Works (CC BY-NC-ND) 4.0 Australia licence. To view a copy of this licence, visit: http://creativecommons.org.au/. You are free to copy and communicate this publication (however in no way commercialise the material), in accordance with the rules of attribution set out at https://creativecommons.org.au/learn/howto/.

Third party material that is not licenced under a Creative Commons licence may be referenced within this document. All content not licensed under a Creative Commons licence is all rights reserved. Please contact the relevant third-party copyright owner if you wish to use this material.

The Heart Foundation acknowledges the Traditional Owners and custodians of Country throughout Australia and their continuing connection to land, waters and community. We pay our respect to them and their cultures, and Elders past, present and future.

For heart information and support, call our Helpline on 13 11 12 or visitheartfoundation.org.au

Suggested citation :National Heart Foundation of Australia. Title : The Women and Heart Disease Forum 2019 Report: National Heart Foundation of Australia 2019

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CONTENTS

Introduction 4

Objectives 4

The day 5

Progress on actions 5

Delegates involvement 6

Identified issues 7

Conclusion 8

Thank you 9

Appendices 10

WOMEN & HEART DISEASE FORUM 2019 3

Key Note speaker Professor Robyn Norton AO

Heart disease in women is not just a women’s issue. It is a societal problem

Forum attendee

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INTRODUCTIONIn June 2019 the Heart Foundation, in collaboration with the George Institute for Global Health, held a one-day forum to showcase emerging research and clinical advances in the prevention, treatment and management of heart disease among women.

Multidisciplinary in focus, this followed the Heart Foundation’s inaugural Women and Heart Disease Forum held in June 2017, where five priorities for action were identified. Namely to:

1. Advocate for a federally funded national campaign to raise awareness of heart disease in women;

2. Facilitate health system changes and sustainable programs to better support women in relation to the prevention, treatment and management of heart disease, including those with vascular complications in pregnancy;

3. Promote greater investment in gender specific research;

4. Ensure future clinical guidelines address sex and gender related issues; and

5. Review relevant undergraduate and post graduate education and training for medical and nursing staff and insert gender related CVD issues into the curriculumi.

OBJECTIVES

In holding the 2019 forum our objectives were to:

Report on the progress made on the above priorities over the last 2 years;

Shine a greater light on the impact of sex and gender on heart disease;

Showcase programs and initiatives that have recognised a life course approach to women’s heart health; and

Agree on our next set of priorities.

WOMEN & HEART DISEASE FORUM 20194

The Honourble Bronnie Taylor MP NSW Minister for Women opening the 2019 forum

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THE DAY

The ProgramIn developing the program, we consciously sought to provide sessions on women’s heart health from a range of perspectives. This included clinicians, researchers, community health professionals and women themselves. For a copy of the program please see Appendix 1. To watch individual presentations, from the Forum please visit the Heart Foundation website and click here

www.heartfoundation.org.au/for-professionals/clinical-information/women-and-heart-disease

We were fortunate in having the Hon. Bronnie Taylor MLC, NSW Minister for Mental Health, Regional Youth and Women, officially open the event, with her account of having been a Breast Care Nurse in the Illawarra for many years and thus knowing the needs to continually advocate for women’s health in rural and regional areas of Australia.

It was also a pleasure to have Professor Robyn Norton AO, Principal Director of the George Institute give the keynote presentation on why disaggregated analysis of sex and gender in cardiovascular research and practice across the life course is so essential to our understanding of heart disease in women, both locally and globally.

ParticipantsOver 260 delegates registered for the day, with representatives from Nursing (36%), Research (24%), Cardiology (12%) and General Practice (6%). See Appendix 2 for a full breakdown by profession and the organisations they represented. This was a significant increase on the 170 delegates who attended the 2017 forum and there were many comments made that with more publicity, the forum could have been run on a larger scale and held over 2 days – such is the interest in the topic.

PROGRESS ON ACTIONS SINCE THE WOMEN AND HEART DISEASE FORUM IN JUNE 2017

The Forum commenced with a reflection on how far we had progressed on actions taken over the last two years. Delegates heard that the NSW branded campaign #womenshearts; Making the invisible Visible had resonated well with the 3 target groups in mind; women, clinicians and researchers, describing in 7 simple words the essence of what we are collectively trying to do. Its success had also formed the basis of an advocacy strategy to the federal government, under the National Women’s Health Strategy 2020-2030 to fund a national women and cardiovascular disease (CVD) campaign.

Secondly, they heard how elements of the NSW Women and Heart Disease Equity Program had been scaled to a national approach under the Heart Foundation’s national One Heart Strategy 2018-2020 and that the community grants made available under the NSW program had strengthened community ownership of this issue locally and resulted in initiatives and programs that were being showcased as part of the 2019 forum.

In terms of impact on clinicians, researchers and health practice, delegates heard that:

the NSW Hearts and Heels female cardiology roundtable had inspired other clinicians around the country to establish a female cardiology network in their jurisdiction, such as VicWIC in Victoria;

the two awarded Women and Heart Disease research grants in NSW (2016 and 2017) had resulted in an overwhelming number of applications for both rounds and had inspired other CVD researchers to look more closely at this issue within their own sphere of work;

That work nationally and internationally on the potential risk of vascular complications in pregnancy was now recognised and reflected in specific resources for women and for GP’s and being made available through Health pathways and other networks, and

The Australian Institute of Health and Welfare (AIHW) had updated its inaugural 2010 Report on the profile of Cardiovascular Disease in Australian Women and would be releasing key findings as part of the forumii.

WOMEN & HEART DISEASE FORUM 2019 5

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DELEGATE’S INVOLVEMENT IN PRIORITY SETTING FOR 2019

One of the key objectives of this Forum was to identify a set of priority actions to inform future planning. Formally delegates were asked to identify what they considered their first, second and third priorities to improve heart health among women as part of their evaluation form. See Appendix 3 for a summary of their responses. But calls for action were also made by experts in the field and in the discussion that followed some of the presentations.

To begin with there were several issues that were consistently identified as key contributors to disparities in care and poor outcomes observed among women with heart disease.

These included:

1. Poorly understood pathophysiology frequently observed in women eg. Myocardial infarction with non-obstructive coronary arteries (MINOCA,) Atherosclerosis, Spontaneous Coronary Artery Dissection (SCAD), and Heart Failure with preserved Ejection Fraction (HFpEF).

2. Low levels of personal awareness of heart disease in women and the competing priorities that many women must attend to.

3. Lack of awareness/bias at a physician level of sex-specific factors in clinical presentation and management.

4. Lack of acknowledgement/understanding of and response to sex-specific CVD risk factors.

5. A paucity of gender disaggregated analyses in research studies and inadequate female representation in preclinical and clinical cardiovascular research.

Responders were keen to emphasise that these should not be seen as isolated issues as they are interrelated in many ways and that an overarching comprehensive approach to address each area is the most effective way to improve the prevention, treatment and management of heart disease in Australian women.

However, to guide health policy responses, key issues and actions to address these issues have been grouped under the following four headings:

Research

Implementation of evidence-based practice

Public awareness/education

Equity

WOMEN & HEART DISEASE FORUM 20196

We have the data to identify the discrepancies in women’s health, but we need to incorporate this into practice

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IDENTIFIED ISSUES AND PRIORITIES FOR ACTIONS

1. RESEARCH

Identified issues:

Poorly understood pathophysiology eg. MINOCA, SCAD, atherosclerosis, HFpEF;

Paucity of gender disaggregated analyses, lack of female representation in preclinical and clinical cardiovascular disease (CVD) research; and

Less adherence to guideline-based care for women.

Priority ACTIONS:

1. Ensure requirements for sex and gender analysis be a mandatory requirement for CVD research funding and publication.

2. Enhance efforts to discover and apply new blood, and imaging markers [eg. mammography, coronary calcification] of subclinical disease and risk relevant to women.

3. Enhance fundamental biological research to unravel sex-specific differences in cardiovascular signalling and pathophysiology that may point to new therapies and strategies of prevention.

4. Establish a national network of multi-disciplinary women’s cardiovascular health clinics, for coordinated efforts aimed at examining the potential benefits of using non-traditional risk factors such as pregnancy events, to risk stratify and alter management in women, and to specifically care and study women who have suffered heart disease or stroke.

5. Investigate reasons why gender disparities continue for in-hospital and post discharge CVD care.

2. IMPLEMENTATION OF EVIDENCE-BASED PRACTICE

Identified issues:

Lack of awareness/bias at a physician level of sex-specific factors in clinical presentation, course and management; and

Lack of acknowledgement/understanding of and response to sex-specific CVD risk factors.

Priority ACTIONS:

1. Improve adherence to current clinical guideline recommendations.

2. Increase commitment to ensuring future Australian clinical guidelines (Absolute Risk, Hypertension, Heart Failure) take into account the impact of sex and gender in their recommendations, through.

a) Review of existing guidelines based on sex-specific data from meta analyses.

b) Addition of gender-specific CV risk factors to current guidelines and CV risk assessment.

3. More investment in inclusion of sex and gender in undergraduate, post-graduate, fellowship training and above.

4. Expand strategies that use a multidisciplinary, life course approach to identify women at risk as they engage with the health system through Obstetrics & Gynaecology, Oncology, Endocrinology & Women’s Health). Priorities include care for women who experience vascular conditions of pregnancy.

5. Greater support for improving gender equity in the cardiology profession in Australia.

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3. PUBLIC AWARENESS-RAISING

Identified issues:

Low levels of awareness & competing priorities among women

Priority ACTIONS:

1. Greater advocacy for implementation of a national women and CVD campaign as stated in the National Women’s Health Strategy 2020-2030.

2. Expand NSW Community Grant Program into other jurisdictions to improve community engagement with high risk populations.

4. EQUITY

Identified issues:

Low levels of awareness & competing priorities among women.

Lack of awareness/bias at a physician level

Lack of acknowledgement/understanding of and response to sex-specific CVD risk factors

Priority ACTIONS:

1. Greater commitment and action to close the gap on Aboriginal and Torres Strait Islander women’s heart health.

2. Continued attention paid to the elimination of Rheumatic Heart Disease and acknowledgement of the impact of this condition on childbearing for Aboriginal & Torres Strait Islander women.

3. Expand NSW Community Grant Program into other jurisdictions to improve community engagement with high risk populations.

CONCLUSION

In the time between 2017 and 2019 we have seen interest in women and heart disease escalate, both nationally and internationally. It is a program priority for most state, national and international heart health organisations and research institutes, and it is a subject of lively debate on twitter and other forms of social media.

In terms of next steps, the Heart Foundation commits to holding another forum in 2 years eg in 2021. We will continue to advocate for the 4 priorities articulated at this forum (research; implementation of evidence-based practice; public awareness raising and equity) and encourage you to do the same. We will work with others in responding to the Federal Minister for Health’s public request to work with CVD researchers to identify research priorities to help improve women’s diagnosis and care in acute medical settingsiii. We will also look to strengthen our relationships with women’s health organisations more generally to ensure our messages are integrated into a more holistic approach to women’s health across the life course.

If you were unable to attend the 2019 forum or would like to see presentations from concurrent sessions you were unable to attend, please view these presentations on our website.

www.heartfoundation.org.au/for-professionals/clinical-information/women-and-heart-disease

Otherwise we wish you well in your efforts to ‘make the invisible visible’.

WOMEN & HEART DISEASE FORUM 20198

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WOMEN & HEART DISEASE FORUM 2019 9

THANK YOU

On behalf of the Heart Foundation I would like to extend our appreciation to the following:

OUR COLLABORATOR: The George institute for Global Health for their energy and support in helping us stage this event.

OUR SPONSORS: Major sponsor, Laverty Pathology for their kind support and UNSW medicine for their session support.

THE HEART FOUNDATION DONORS AND SUPPORTERS: Our donors and supporters who have enabled the NSW Women & Heart Disease Program 2015-2018 to be rolled out as a comprehensive program working with community, clinical and research partners and helped light the spark that has become a movement.

THE HEART COLLECTIVE: who are an inspirational group of women living with heart disease who support this cause with passion, advocacy, commitment and generosity. It’s been their stories that have been an inspiration to much of what we have done. Thank you for sharing your personal experiences and stories and helping other women feel not so alone.

MEMBERS OF THE HEARTS AND HEELS CARDIOLOGY ROUNTABLE: Female cardiologists who belong to this group helped us shape the 2019 program and gave their time willingly to present and chair various sessions throughout the day. It was invaluable. Thank you in particular to A/Professor Lynne Pressley for her guidance and generosity.

FORUM PRESENTERS: There were many presenters from a range of disciplines we reached out to both in NSW and in other jurisdictions such as Queensland, Victoria, South Australia, ACT and Northern Territory. Thank you for your time and willingness to share your expertise.

THE HEART FOUNDATION TEAM: Thank you to all of the Heart Foundation staff who contributed to making this Forum happen. Special thanks is extended to Angela Hehir, Women & Heart Disease Manager, along with the Event team Jayne Farley, and Celeste Ambalong, who made the day the success that it was.

Julie Anne Mitchell

Director of PreventionAugust 2019

This was one of the most rewarding conferences I have attendedForum attendee

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APPENDIX 1:1. Program for The Day

P R O G R A M M E

9.00 - 9.15 Welcome Sophie Scott, National Medical Reporter, ABC

Official opening The Hon. Bronnie Taylor MLC, NSW Minister for Mental Health, Regional Youth and Women

Welcome to Country Ms Yvonne Weldon

9:15 – 9:30 Women & Heart Disease Julie Anne Mitchell; Director of Prevention, Heart Foundation Sophia Malie and Doris Williams; Tharawal Aboriginal Corporation Michelle Hampton; Founder Magnum & Co

9.30 - 9.55 KEYNOTE PRESENTATION:

Change of Heart: a move to sex and gender disaggregated cardiovascular research and practice across the life-course Prof Robyn Norton AO; Principal Director, The George Institute for Global Health

PLENARY SESSION 1

THE FEMALE PATTERN OF CORONARY HEART DISEASE – WHAT DOES THIS LOOK LIKE AND HOW DO WE TREAT IT?

10.00 - 10.15 Heart disease in women: from diagnosis to treatment to outcomes Dr Clare Arnott; Cardiologist, Royal Prince Alfred Hospital, Senior Research Fellow, Cardiovascular Division, The George Institute

10.15 - 10.30 Treatment of MI in women – why is it different and what is the impact? Prof Clara Chow; Professor of Medicine and Academic Director Westmead Applied Research Centre, University of Sydney

10.30 - 10.45 Chest pain and normal angiography in women – could it be cardiac? Prof John Beltrame; Head of Discipline of Medicine, Queen Elizabeth Hospital, Adelaide

10.45 - 11.00 Sex and the myocardium - insights from cardiovascular magnetic resonance imaging Prof Martin Ugander; Professor of Cardiac Imaging, Department of Cardiology, Royal North Shore Hospital, University of Sydney

11.00 – 11.10 Questions

Morning tea: 11.10-11.40 • Level 1 Lounge

WOMEN &

FORUM 2019HEART DISEASEJ U N E 1 9 , 2 0 1 9 | 9 A M - 5 P M

Major supporters

1.20 – 2.20

HEART HEALTH ALONG THE LIFE COURSE • Chair: Dr Amanda Beech

Gestational Diabetes: A Red Flag Dr Amanda Beech; Obstetric Medicine Physician & Endocrinologist, Staff Specialist Royal Hospital for Women and Prince of Wales Hospital

The National Gestational Diabetes Register: overview, evaluation & next steps Dr Melinda Morrison; National Program Leader, NDSS Diabetes in Pregnancy Program

Polycystic Ovary Syndrome – the risk factor you may not have heard about A/Prof Lisa Moran; Head, Healthy Lifestyle Research Program, Heart Foundation Future Leader Fellow, Accredited Practising Dietitian; Monash Centre for Health Research & Implementation, School of Public Health & Preventive Medicine, Monash University – in partnership with Monash Health

Breastfeed to your heart’s content Dr Binh Nguyen; Research Fellow, Prevention Research Collaboration, Sydney School of Public Health, University of Sydney

Hormones and heart health across the life-course Dr Anastasia Mihailidou; Senior Hospital Scientist, Cardiology Department, RNS and Head, Cardiovascular & Hormonal Research Laboratory, Kolling Institute

ASK THE EXPERTS PANEL

CONCURRENT SESSION 2 - DELEGATES TO SELECT ONE OUT OF THE THREE LISTED

Afternoon tea: 2.20-2.50

WOMEN’S ULTIMATE STRESS TESTS • Chair: Prof Gemma Figtree

Pregnancy: Women’s ultimate stress test Prof Gemma Figtree; Prof in Medicine Uni of Sydney; Interventional Cardiologist Royal North Shore Hospital

Update on the final ROPAC [Registry of Pregnancy and Cardiac Disease] Prof Will Parsonage; Senior Staff Cardiologist, Royal Brisbane & Women’s Hospital, Clinical Director AusHSI, IHBI, Queensland University of Technology

Advances in management of pregnancy in women with congenital disease Dr Rachael Cordina; Cardiologist, Royal Prince Alfred Hospital

Heart of the female athlete Dr Belinda Gray; Cardiologist at Royal Prince Alfred Hospital, NHMRC Early Career Fellow at University of Sydney

Spontaneous Coronary Artery Dissection Dr Clare Arnott; Cardiologist, Royal Prince Alfred Hospital, Senior Research Fellow, Cardiovascular Division, The George Institute

ASK THE EXPERTS PANEL

HEALTH SYSTEM RESPONSES & BREAKING DOWN SILOS • Chair: Denele Crozier AM

Women’s heart health: and the importance of a cross disciplinary approach Annie Flint; Manager Women’s Health, Child Youth & Family, Southern NSW LHD and Denele Crozier AM; CEO Women’s Health NSW

NSW Health: what the health system can do Dr Marianne Gale; Medical Advisor in the Office of the Chief Health Officer, NSW Ministry of Health

Women’s Health NSW – piloting a strategy to assess & manage cardiovascular risk Debra Pittam; Principal Consultant Coach and Facilitator, Person Centred Leadership

Beyond the Health System to end RHD Dr Rosemary Wyber; GP and Head of Strategy END RHD, PhD Student, Office of the Chief Scientist, The George Institute

Cancer and the Heart Prof Liza Thomas; Conjoint Professor at Sydney University and University of NSW, Clinical Lead for non- invasive cardiac imaging, Westmead Hospital

ASK THE EXPERTS PANEL

CONCURRENT SESSION 1 – DELEGATES TO SELECT ONE OUT OF THE THREE LISTED

11.40 – 12.40

POPULATIONS OF WOMEN AT RISK • Chair: Dr Marcus Ilton

Rheumatic Heart Disease Dr Marcus Ilton; Interventional Cardiologist, Darwin Private Hospital

Cardiovascular Disease: Protective and risk factors for Aboriginal women Katharine McBride; Research Officer, SAHMRI

HeartSmart – Prevention and awareness for Women from CALD communities Sharda Jogia; Senior Women’s Health Promotion Program Manager, SWSLHD

Healthy hearts for women in custody Shani Prosser; Manager Health Advancement, Justice Health and Forensic Mental Health Network

Rural and remote issues: distance and the heart – a film project of women’s stories Nerida Colley; Health Promotion Projects Officer, Lismore Women’s Health and Resource Centre

ASK THE EXPERTS PANEL

HEART DISEASE IN WOMEN – WHAT DOES IT LOOK LIKE & HOW IS IT DIFFERENT • Chair: Dr Elizabeth Shaw

Presentation and diagnosis of ACS in the ED: Are Women really that different to men? Prof Louise Cullen; Pre-Eminent Staff Specialist Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital

Sex differences in Acute Coronary Syndromes Dr Sarah Zaman; Interventional and Consultant Cardiologist, MonashHeart and Monash University

Sex difference in heart failure risk factors and phenotype: what we know and the implications for women Dr Anna Beale; Cardiology Advanced Trainee, Alfred Hospital and PhD candidate, Monash University/Baker Heart and Diabetes Institute

Sex differences in inherited heart diseases and sudden cardiac death A/Prof Jodie Ingles; Head, Clinical Cardiac Genetics Group, Centenary Institute

Mapping coronary artery disease reveals fundamental gender differences Dr Susann Beier; Principle Investigator, Coronary Atlas UNSW

ASK THE EXPERTS PANEL

HYPERTENSION IN PREGNANCY – THE IMPACT ON HEART HEALTH • Chair: Dr Clare Arnott

This session sponsored by The University of New South WalesIntroduction by Jonathan Pheasant; UNSW Medicine Faculty Executive Director

The P4 & BP2 Study into reducing women’s risk post preeclampsia Dr Amanda Henry; Senior Lecturer, School of Women’s and Children’s Health, UNSW, Senior Research Fellow, Global Women’s Health Program, The George Institute

Impacts of preeclampsia on the long-term health of mothers and their children A/Prof Vincent Lee; Renal Physician, Westmead Hospital

The COFFEE clinic: cardiovascular assessment after obstetric complications - follow up education and evaluation A/Prof Margaret Arstall; Director of Cardiology, NALHN, Associate Professor, University of Adelaide

Supporting women with preeclampsia to reduce their risk through healthy lifestyle change Dr Melinda Hutchesson; Senior Lecturer (Nutrition and Dietetics) University of Newcastle

ASK THE EXPERTS PANEL

Lunch: 12.40-1.20

PLENARY SESSION 2

WOMEN & HEART DISEASE RESEARCH REPORTS

2.50 – 3.00 Women’s experiences of heart disease in pregnancy Prof Liz Sullivan; Deputy Head, Faculty of Health and Medicine, University of Newcastle

3.00 – 3.10 Using big data to inform our understanding of heart disease in Australian women Prof Emily Banks; Professor of Epidemiology, Australian National University

3.10 – 3.20 CVD in Australian women – a snapshot of national statistics Miriam Lum On; Cardiovascular, Diabetes and Kidney Unit, Health Group, Australian Institute of Health and Welfare (AIHW)

HEART DISEASE IN WOMEN & THE IMPACT OF GENDER

3.25 – 3.35 Matters of the heart and mind: how mental health impacts women’s heart health A/Prof Adrienne O’Neil; Director of Heart and Mind Research, Deakin University and Heart Foundation Future Leader

3.35 – 3.45 Women in cardiology – why is this important? Dr Sonya Burgess; Interventional cardiologist and consultant cardiologist, Nepean Hospital and Sydney South West Hospital

3.45 – 3.55 Break

3.55 – 4.05 Sex and Gender Differences – why research is important Dr Jenny Yu; Interventional Cardiologist, Prince of Wales Hospital

4.05 – 4.15 My take-outs from the day A/Prof Lynne Pressley AM; Chair, Heart Foundation Hearts and Heels Cardiology Roundtable

4.15 – 4.45 EXPERT PANEL AND OPEN DISCUSSION:

Facilitated by Sophie Scott, National Medical Reporter, ABC

Prof Chris Semsarian AM; Chair, CSANZ Scientific Committee Denele Crozier AM; CEO Women’s Health NSW Leah DSouza; Patient Representative Dr Linda Mann; GP, Young Parents Pregnancy Clinic, Royal Prince Alfred Hospital David Lloyd: CEO Jean Hailes Foundation Dr Melina Georgousakis; Founder, Franklin Women Dr Sarah Zaman; Chair, Women in Cardiology

4.45 – 5.00 Summary of Priority Actions and Final Words Angela Hehir; Manager, Women & Heart Disease, Heart Foundation Prof Garry Jennings; Chief Medical Advisor, Heart Foundation Jo Dean; Heart Collective

5.00 – 6.00 POST FORUM NETWORKING DRINKS AND CANAPES

For bookings - www.trybooking.com/462470WOMEN &

FORUM 2019HEART DISEASEMajor supporters Session supporter

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HOSPITALS

Albury Hospital, AWHAlfred Hospital, MelbourneBankstown HospitalBankstown-Lidcombe HospitalBowral and District HospitalCabrini Hospital/Victorian Heart & Lung ClinicCardiac Rehab Sutherland HospitalChildren’s Hospital WestmeadDarwin HospitalFiona Stanley HospitalJessie McPherson Private HospitalLake Macquarie Private HospitalMaitland HospitalNorth Shore Private HospitalNepean HospitalPrince of Wales HospitalQueen Elizabeth Hospital, AdelaideRNS HospitalRoyal Hospital for WomenRoyal Melbourne HospitalRoyal North Shore HospitalRoyal Prince Alfred HospitalSt George Private HospitalSt Vincent’s Private HospitalSunshine Coast University HospitalSutherland HospitalSydney Adventist HospitalThe Canberra HospitalThe Queen Elizabeth HospitalWestmead Hospital

UNIVERSITIES

Australian National UniversityDeakin UniversityFlinders UniversityMacquarie UniversityMonash UniversityThe University of Sydney University of AdelaideUniversity of NewcastleUniversity of Technology SydneyUniversity of WollongongUniversity of NSWCentenary InstituteWestern Sydney UniversityCoronary Atlas - UNSW

PRIMARY HEALTH

Barton Lane PracticeTharawal Aboriginal Corp AMSBalmain Community Pharmacy

CARDIOLOGY SERVICES

Capital Cardiac Centre, CanberraMosman CardiologyEastern Health, Bond Cardiology

PRIVATE ORGANISATIONS

Australian American MediaLaverty Pathology LDS ConsultingMagnum & CoPerson Centred Leadership

APPENDIX 2: AttendeesThis was the breakdown by profession of those who attended on the day.

Listed below are the organisations they represented.

Delegates

Video

Research

Cardiology

GP

Health Promotion

Other Specialty

Consumer

Project O�cer

Policy

36%

24%

3%3%4%

6%

6%

6%

12%

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WOMEN & HEART DISEASE FORUM 201912

HEALTH DEPARTMENTS / SERVICES

Illawarra Shoalhaven Local Health DistrictLower Hunter Community HealthMurrumbidgee Local Health DistrictNational Aboriginal Community Controlled Health OrganisationNorthern NSW Local Health DistrictNational Rural Health AllianceNSW Ministry of HealthNSW Multicultural Health Communication ServiceOffice for Health and Medical ResearchOffice of Preventative HealthSA HealthSouth East Sydney LHDSouth West Sydney LHDSydney North Health NetworkHealth Clinical Academic GroupWestern Sydney Local Health DistrictAustralian Institute of Health and WelfareAustralian Centre for Heart HealthBendigo HealthCentral Adelaide Local Health NetworkCentral Coast Local Health DistrictCoffs Harbour Health CampusCommonwealth Department of HealthDepartment of HealthGeorge Health TechnologiesGeorge Institute for Global HealthHNE HealthJustice Health NSW AmbulanceNepean Blue Mountains Local Health DistrictCentral Adelaide Local Health NetworkDiabetes NSWSAHMRI

WOMEN’S HEALTH

Bankstown Women’s Health CentreFranklin WomenHer HeartIllawarra Women’s Health CentreJean Hailes for Women’s HealthLismore Women’s Health and Resource CentreLiverpool Women’s Health centrePenrith Women’s Health CentreSchool of Women’s and Children’s HealthWomen’s Health NSWWomen’s Health, South Eastern Sydney LHD

COMMUNITY / NON-GOVERNMENT / PROFESSIONAL ORGANISATIONS

CASSEND RHDHeart FoundationHeart Research InstituteHeart Research InstituteVictor Chang Cardiac Research InstituteYoung Hearts CSANZ

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Appendix 3: Evaluation Attendees were invited to complete a feedback/evaluation form on the day or via Survey Monkey posy event. A total of 92 completed surveys were received and responses are summarised below.

RESEARCH “There is an enormous gap in female cardiovascular research” “Women are not adequately represented in the data” “Sex and gender disaggregated research is important”

AWARENESS-RAISING CAMPAIGN “Teach women that they may experience different chest pain to men” “Spread the word” “Giving patients an awareness of gender and heart” “Creating awareness of risk factors” “Public awareness campaign”

IDENTIFICATION OF THOSE AT RISK “Continuing to raise awareness especially to pregnant women” “Increase community awareness of the long-term CV risk of women after a complicated pregnancy” “Addition of pregnancy related risk factors into GP screening and checks” “Higher risk in Aboriginal people and CALD community” “Indigenous women have a very different view of heart health”

INHOSPITAL CARE “Low rates of referral for rehab and prescription of medication” “Encourage women to attend cardiac rehab” “Lower participating in cardiac rehab – unpack”

PROFESSIONAL DEVELOPMENT “How few cardiologists are female” “Cardiology trainee gender disparity” “Better training of GPs awareness of cardiac risk in women” “Having more female doctors at the first point of contact for a woman experiencing chest pain” “Get more male cardiologists on the page” “Engaging men would be great to see more at the forum”

EQUITY “Women are a high-risk group, especially Aboriginal and refugee populations” “Programs for populations of women at risk” “Higher risk in Aboriginal people and CALD community” “There is significant community interest in this area” “There has been very little research with CALD and refugee women” “Indigenous women have a very different view of heart health” “Aboriginal model of health” “Various strategies to engage and educate CALD communities”

General Feedback:

“We need to keep working to overcome the barriers women face everywhere!”

“This was one of the most rewarding conferences I have attended”

“We need to encourage more male doctors to be attending in order to reduce the gaps in women’s health”

“Heart disease in women is not just a women’s issue. It is a societal problem.”

“Having more female doctors at the first point of contact for a woman experiencing chest pain”

“We have the data to identify the discrepancies in women’s health, but we need to incorporate this into practice”

“Ensuring equitable access to services and supports”

“Excellent day – very thought provoking”

“Insightful and relevant”

“This seems to be gaining momentum and the hearts of the researchers”

“Lets expand the forum to 2 days and make it truly national in focus.”

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WOMEN & HEART DISEASE FORUM 201914

EvaluationResponses from delegates to the evaluation questions

1. Change in Awareness About Impact of Sex and Gender:

2. Likelihood of considering sex and gender in future everyday practice:

3. Awareness of the major sponsor of the event

73% of survey respondents identified Laverty Pathology as the major sponsor for the event.

0

2010

4030

6050

8070

10090

Before Today A�er Today

Very Aware Aware Not Very Aware Not Aware Unsure

% Aware of impact of sex and gender on the experience of heart disease

% Likely to consider sex and gender in future practice

Very Likely Likely Unlikely Not applicable

82%

14%

3%1%

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WOMEN & HEART DISEASE FORUM 2019 15

4. Survey respondents were asked to identify their first, second and third priorities to improve heart health among women. Their responses are summarised below:

RAISE AWARENESS

NETWORKING

MEN ENGAGEMENT

INTERVENTION, PREVENTION

GENDER-SPECIFIC RESEARCH

FUNDING AND GUIDELINES

COLLABORATE, IMPLEMENT

CLINICAL EDUCATION

First Priority

0 5 10 15 20 25 30

15%

0%

23.75%

3.75%

13.75%

26.25%

5%

6.25%

RAISE AWARENESS

NETWORKING

MEN ENGAGEMENT

INTERVENTION, PREVENTION

GENDER-SPECIFIC RESEARCH

FUNDING AND GUIDELINES

COLLABORATE, IMPLEMENT

CLINICAL EDUCATION

Second Priority

0 5 10 15 20 25 30

23.94%

0%

29.58%

14.08%

16.9%

12.68%

2.82%

0%

RAISE AWARENESS

NETWORKING

MEN ENGAGEMENT

INTERVENTION, PREVENTION

GENDER-SPECIFIC RESEARCH

FUNDING AND GUIDELINES

COLLABORATE, IMPLEMENT

CLINICAL EDUCATION

Third Priority

0 5 10 15 20 25 30

29.17%

0%

33.33%

10.42%

12.5%

2.08%

6.25%

0%

35

Priority 1 Priority 2 Priority 3

Post Forum Action Survey: % Priorities Identified 2019

0

5

10

15

20

25

30

35

Gender-specificResearch

Funding andGuidelines

ClinicianEducation

RaiseAwareness

Intervention,Prevention

References i Heart Foundation Report on the 2017 Women and Heart Disease Forum understanding risk, diagnosis and management ii AIHW Cardiovascular disease in women Report released 22 July 2019 www.aihw.gov.au/reports/heart-stroke-vascular-diseases/

cardiovascular-disease-in-women-main/contents/summaryiii Newscorp article published 3rd March 2019 www.news.com.au/lifestyle/health/women-are-dying-because-of-endemic-health-system-

discrimination/news-story/0037ea9a864ec31e30200ad2f1c9769

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HH-PRISK-021.1.1219