Women's College Research Institute

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Women's Cardiovascular Health Initiative

The Women's Cardiovascular Health Initiative (WHCI) is Canada's first comprehensive assessment and lifestyle program for women with existing or potential heart problems. The program is comprised of a three-month primary prevention program for women with multiple risk factors and a six-month cardiac rehabilitation program for women with heart disease. A multi-disciplinary health-care team provides risk factor modification counselling services and education sessions and participants are offered enrollment into a women's exercise training program.

Dr. Len Sternberg oversees the clinical and research program. Clinical researchers, including clinical nurse specialist Jennifer Price and physiotherapist Mireille Landry, work as part of the program studying the benefits of this woman-focused model of care.

The goal of our program is to enhance adherence, outcome and quality of life through cardiac rehabilitation, which in the past has been one of the most underused interventions in women. In particular, investigators explore whether tailoring cardiac rehabilitation specifically to women's needs can improve their health outcomes more effectively and help them stay involved in the program. Program volume has been continually expanding due to increasing demand with approximately 2900 visits this past year. Evaluation outcomes to-date have been extremely positive, with a six month adherence rate of over 85 per cent, even in the older subgroup (>65 years of age), compared to historical average of 40 to 60 per cent. Our patients also demonstrate an average of 50 per cent improvement in exercise capacity, much higher than the historical average of 20 to 30 per cent. These findings have been presented at a number of key venues including the American Heart Association and the Canadian Cardiovascular Society annual scientific meetings, and the First International Conference on Women and Heart Disease and Stroke.

Clinical investigators at the Women's Cardiovascular Health Initiative also explore the effectiveness of specific health interventions, such as cognitive behavioural therapy to help women deal with depression and anxiety. The presence of anxiety and depression after a coronary event is a predictor of cardiac morbidity and mortality, and is cited as a common reason why women spend less time in physical activities and are less likely to participate in or complete cardiac rehabilitation programs. 


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  • Fully affiliated with:
  • University of Toronto

  • A member of:
  • Council of Academic Hospitals of Ontario (CAHO)