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It’s ticked over a year since Ive returned to Deakin @IMPACT to set up Heart & Mind Research and Ive been reflecting on what we’ve achieved and where we’re going. Here’s a brief summary:
Our first paper found the evidence underpinning current heart attack guidelines in Australia lacks female representation.
18% of studies reported sex-disaggregated results for primary outcomes
23% of studies included sex in the analytic model https://pubmed.ncbi.nlm.nih.gov/31526681/
18% of studies reported sex-disaggregated results for primary outcomes23% of studies included sex in the analytic model https://pubmed.ncbi.nlm.nih.gov/31526681/
Given the striking absence of evidence focussed on women, we set out to better understand women’s trajectories after heart attack. We found that from a physiological perspective, women have poor autonomic functioning in the 12 months post cardiac event https://www.sciencedirect.com/science/article/abs/pii/S1443950620303784
They experience more worry and depression in this period and do not benefit to the same extent as their male counterparts who more often receive stents https://www.sciencedirect.com/science/article/abs/pii/S1443950620300755
There are various pathways by which poor mental health drive worse cardiac outcomes both before and after clinical manifestation of CVD which we detailed in the Special Edition of HLC with @drbarbmurphy https://www.sciencedirect.com/science/article/abs/pii/S1443950620302857
These drivers are not just physiological, they are biopsychosocial. We found some evidence that being married is protective of CVD mortality but this was (unsurprisingly) more pronounced for men https://ghrp.biomedcentral.com/articles/10.1186/s41256-020-00133-8
But perhaps the most striking driver of women’s heart health, like mental health, is socio-economic. Income shapes women & girl’s health from the moment they are born especially for Indigenous, WOC & those born into poverty https://www.sciencedirect.com/science/article/pii/S0378512220302905
Rates of CVD have been increasing at an unprecedented rate in pre-menopausal women and we wanted to understand why. So we looked to the US where economic disparities are especially great. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2020.305702
Again not all women are at the same level of risk; a woman of color living with a disability in poverty is at much higher CV risk than a white, educated, middle class woman. We found possible trends between higher CVD incidence & lower gender equality rankings at State level.
Employment is a key constituent of gender equality & determinant of health-especially in the COVID context & gig economy. We found women’s mental health is more likely affected by long working hours and men’s by precarious employment https://oem.bmj.com/content/early/2020/08/14/oemed-2019-106281.abstract
All of this has important implications- especially in the COVID-19 era- for how clinicians consider mental health in the management of heart health . Here are some tips 
https://www.sciencedirect.com/science/article/pii/S1443950620301438
https://www.sciencedirect.com/science/article/pii/S1443950620301438
Finally, a huge thank you to Josie Russell, Robyn Perlstein, @AScovelle, @kelly_thompson_ and our collaborators at @georgeinstitute, Monash Heart, Wuhan University and Oxford University.
Next thread – how we can use what we know works in lifestyle medicine for cardiac patients by applying it to mental health patients & settings. Our work at @foodmoodcentre !! 
And a HUGE thank you @heartfoundation for the support you've provided me since I was a wee PhD student in 2009 and most recently as a Future Leader Fellow. Couldn't have done this without your support 
