Healthy Living in the North

Screening & follow-up care to prevent cardiovascular disease in women in Prince Rupert

This article was co-authored by Justine Derksen and Janice Paterson


Doctor in scrubs

Evidence has shown that pregnancy is a great place to evaluate cardiac risk. In Prince Rupert, Dr. Marius Pienaar has developed a screening program and software to identify and support women with cardiovascular risks.

Scientific evidence has shown that pregnancy is a great place to evaluate cardiac risk. In Prince Rupert, Dr. Marius Pienaar, a gynecologist, has developed a screening program and software which uses the data collected during a woman’s pregnancy to assess for cardiovascular risks and to coordinate referral and follow-up to prevent cardiovascular disease.

During the pregnancy, some basic measurements such as blood pressure and weight are recorded and a panel of blood tests are performed, including blood lipids and glucose. This data is then entered into the program to calculate a risk score for future cardiovascular disease. Women with elevated risk are then offered interventions, and their primary care provider is informed of this risk.

We have a golden opportunity to evaluate pregnant women with cardiovascular risk and this should not be missed. -Dr. Marius Pienaar

Dr. Pienaar explains that if a woman has diabetes in pregnancy, she is at a higher risk of having diabetes later in life and should be tested 6 weeks to 6 months after pregnancy. Currently, only about 20% of women are tested after pregnancy. Dr. Pienaar’s new software actively follows his patients and has created a referral and reminder system where every patient can be contacted and given opportunities to attend the North Coast Maternal Health Clinic for evaluation.

Walking in snow with mountain background.

Dr. Pienaar is hoping to make this unique program and software available across the province.

Currently, Dr. Pienaar’s clinic seeks to intervene by providing clinical care to at-risk women as well as offering smoking cessation resources, on-site dietitians and diabetes nurses, and more. 100% of postpartum patients who are screened and are identified as having increased risk are offered the postpartum health clinic visit. The program is expected to increase patient awareness of their own risk of cardiovascular disease and support women to access additional health care services to help reduce their risk.

I am very appreciative of the care and information I received in the North Coast Maternal Health Clinic. This program provided me with valuable information/assessment regarding future health risks. Such insight allows me to intervene early in order to improve my modifiable risk factors and ensure my future health and well-being. -Cherie Harvey-Malthus

The clinic has been a success so far and is very efficient and cost effective. Dr. Pienaar has seen success with this quality improvement project and hopes to make the program and software available across the province. There has already been interest from Fraser Health and the Lower Mainland to emulate the clinic model at other hospitals. This is the first such clinic in B.C. and the first rural clinic in Canada specifically geared to evaluate cardiovascular risk in postpartum patients.

Check out the full version of this article: An Innovative Program in Prince Rupert is Screening and Providing Follow-up Care for Women with Risk for CVD

Justine Derksen

About Justine Derksen

Justine works for Northern Health in Medical Affairs as the Coordinator, Physician Engagement Initiatives in Prince George. Justine loves the north and enjoys the seasonal activities with her husband and adorable Bernese Mountain dog any chance she gets. Justine is currently pursuing her masters of Public Health degree, which she was inspired to pursue through her work with Northern Health. When not at work, Justine enjoys cooking, outdoor recreational activities and crafting.

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Heart Month: Get up, get healthy

Northern Health staff at a Canada Winter Games venue

Throughout the 2015 Canada Winter Games, Northern Health has been asking residents and visitors how they are getting their 150 minutes of physical activity each week. For Heart Month, Zack has some great tips for how to become more active, more regularly and why it’s important to get those 150 minutes!

After a hard day of work in the office or wherever your job may be, it can be difficult to have any ambition left to go out and exercise. I think that it’s fair to say that everyone knows that it’s important to include physical activity and exercise in your day, but knowing that and doing it are two very different things. However, February is Heart Month so it’s a good time to think about the health of your heart! Among the many benefits of physical activity, improving the health of your heart is one of the most important ones.

Not convinced? Some of the ways that physical activity can improve the health of your heart include:

  • Preventing high blood pressure
  • Improving cholesterol levels
  • Reducing stress
  • Improving sleep
  • Improving circulation (which is especially important for older adults)
  • Reducing the risk of heart disease, stroke and diabetes

For those of you who don’t regularly engage in physical activity, there is good news! Research has shown that the greatest improvements in cardiovascular health can be seen in those who change from sedentary to more active lifestyles. This means that it is never too late to get up and start moving, and that your heart will thank you for doing so!

Some people may find the thought of exercising or working out to be intimidating, but it doesn’t have to be that way! Studies have shown that many different forms of physical activity can improve your cardiovascular health; it’s about meeting yourself where you’re at and going forward from there. One study showed that exercise in the form of regular physical activity incorporated into everyday living was equally effective at improving cardiovascular health when compared to structured exercise regimens.

Speaking from my experience, I know that regular exercise can be an extremely difficult thing to do and that ambitious intentions can often lead to big disappointments. As a person who has tried very hard to exercise regularly for the past several years and has encountered both challenges and successes, here are my tips to help you become active more regularly and to become a healthier, happier version of yourself:

  • Don’t like it? Don’t do it! Many people I know think that jogging, running, or going on the treadmill or elliptical machine is the ultimate form of exercise for your heart. I disagree! Any activity that increases your heart rate and makes you breathe harder is a cardiovascular workout with the same benefits for your heart! If you’re like me and aren’t a fan of running or elliptical machines, some great forms of cardiovascular exercise that I would suggest are brisk walking, hiking, paddling, bike riding, swimming, snowshoeing, and weight lifting with weights that are light enough for you to do a high number of repetitions. Make sure that whatever you’re doing, you’re enjoying it!
  • Don’t use the scale to measure your success. Your weight is not the best way to measure your health. Healthy bodies exist in a diversity of shapes and sizes! Although physical activity can help you to achieve a healthy weight, there are many other, more important benefits of physical activity for your body.
  • Set realistic, SMART goals. Realize that a small amount of physical activity done regularly is much more beneficial to your health in the long run than short-lived fads of intense exercise.
  • Environmental changes. Once you have the desire to become more active, the next step should be to implement a few small environmental changes to help ensure that you get active by being more organized and making physical activity more convenient. Examples of this would be throwing your running shoes in the car so that you can go for a walk on lunch break, signing up for a gym that is close to your home or on the way from your home to work, or packing your bag with whatever you will need for your activity the next day and putting it right by the door.
  • Find an exercise buddy. Exercising with a friend can not only make your activity more social and enjoyable, but they can often help you get out and be active on those days when you’re not feeling motivated to do so (and you’ll have the same impact on them!). I have often found that when my workout buddy drags me out for exercise on those days when I’m experiencing low energy and low motivation, I come home feeling much better than I ever did before exercising.

Visit the Canadian Society for Exercise Physiology for information on Canada’s Physical Activity Guidelines or visit the Heart & Stroke Foundation for more information about Heart Month and cardiovascular health.

Zachary Kohlen

About Zachary Kohlen

Zachary Kohlen is a fourth year nursing student at UNBC in Prince George. He is currently completing a practicum for Community Health & Nursing with the Population Health team. Prince George is home to Zack, as he has lived here for the past 14 years. Other than homework and studying, he enjoys snowboarding, swimming, golfing, weight training, hiking and camping. Zack has had the opportunity to take part in a number of health promotion activities with the Northern Health team for the 2015 Canada Winter Games.

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