Johanna Contreras and Lupe Share Insights from the Cuide Su Corazón Campaign

Shots:

Johanna Contreras, Director of the Ambulatory Heart Failure Network & Diversity Mount Sinai Health System spoke about the initiation of this campaign and how it is empowering Latina women with heart failure to prioritize their heart health
Lupe, a woman diagnosed with heart failure, shared her experience of her life with heart failure and how this campaign helped her in the improvement of her condition
Cuide Su Corazón is the second phase of the Hear Your Heart campaign launched in April 2022 by Boehringer & Lilly. The program was built to deepen the connection with Latina women living with heart failure in Spanish-language content and resources to support these women

Conversation with Johanna Contreras

Smriti: Briefly tell us about the Cuide Su Corazón campaign. What led to the initiation of this campaign?

Johanna: Cuide Su Corazón, the Spanish-language extension of Hear Your Heart, is an initiative that aims to combat health disparities and inequities for Latina women with heart failure. This initiative is grounded in research and data that shows significant health disparity and equity issues exist in the treatment of heart failure for women, especially Latina women. Hear Your Heart/Cuide Su Corazón is a call-to-action for women with heart failure, especially Black and Latina women, to prioritize their health and feel confident in asking for the resources they need to feel their best while managing their condition.

Hear Your Heart is a phased initiative that initially launched in April of 2022 with resources and educational content that addressed health disparities and inequities for both Black and Latina women living with heart failure, encouraging proactive conversations with their care teams to help better manage their care.

Cuide Su Corazón, the second phase of the program, was built off the initial launch to deepen the connection with Latina women living with heart failure with culturally relevant, Spanish-language content and resources to support these women and ensure they feel confident in asking for what they need to feel their best.

Smriti: What could be the possible reason behind African American and Latina women not being able to receive the best possible care for their heart failure?

 “One in three Latina women have a form of cardiovascular or heart disease, and yet studies suggest that Latino adults are the racial and ethnic group least likely to visit a doctor’s office”

Johanna: Black and Latina women face many unique challenges and barriers that prevent optimal care. A variety of social determinants of health, including health literacy, socioeconomics and environmental influences, can contribute to poor health outcomes. In terms of heart failure specifically, Black and Latina communities have higher rates of diabetes, obesity and high blood pressure which can lead to heart diseases, including heart failure. 

Additionally, significant health disparity and equity issues exist in the treatment of heart failure for women, especially Black and Latina women. Most notably: 

Black and Latina women living with heart failure are less likely to be admitted to specialized cardiology units, and Black women with heart failure have a greater mortality rate than white women.
Hispanic women on average are more likely to develop heart disease 10 years earlier compared to non-Hispanics, and yet only one-third know it is their greatest risk of death.
One in three Latina women have a form of cardiovascular or heart disease, and yet studies suggest that Latino adults are the racial and ethnic group least likely to visit a doctor’s office. The reasons will vary from person to person but may include a strong preference for cultural or family remedies, distrust in the medical system, language barriers, lack of time, or even some combination of all.

As a Latina, I understand the cultural nuances that can complicate and, in some cases, prevent proper care. My hope is to help women understand that it’s possible to prioritize your personal health while still honoring who you are.

Smriti: How does this campaign address the need to maintain equity and health disparity issues for African American and Latina women with heart failure?

Johanna: Hear Your Heart/Cuide Su Corazón provides resources and education for women with heart failure, especially Black and Latina women, to help prioritize their care. Resources are also available for care partners who are helping someone through heart failure management, as well as for healthcare professionals to further educate on the unique considerations for treating women with heart failure, especially Black and Latina women.

Current educational materials – with select resources available in Spanish – can be found on HFHearYourHeart.com/CuideSuCorazonIC.com and include:

Empowering videos featuring Tannie and Lupe, women living with heart failure
Informative videos featuring myself and cardiologist Dr. Alanna Morris to provide expert perspectives to help women be proactive and engaged in their care
A resource for people living with heart failure to help them manage their care
A resource for care partners who are supporting someone with heart failure
A resource for healthcare professionals who are treating those with heart failure

Smriti: Can you elaborate on how this campaign has helped these African American and Latina women to advocate for themselves and receive proper care?

“Hear Your Heart/Cuide Su Corazón encourages proactive, ongoing conversations and provides actionable steps for women living with heart failure to help improve outcomes”

Johanna: Managing heart failure is complex and every journey is different. There’s so much that goes into care, including making lifestyle changes, managing mental health, securing the right care team and ensuring associated conditions are managed accordingly. Hear Your Heart/Cuide Su Corazón encourages proactive, ongoing conversations and provides actionable steps for women living with heart failure to help improve outcomes.

Current program resources include inspiring real patient stories, tips from healthcare professionals and additional educational tools, which can help Black and Latina women with heart failure reflect on their heart health, determine how they can take a more proactive role in their care and become their own heart success advocate. Hear Your Heart/Cuide Su Corazón resources tackle many aspects of heart failure care and resources can be found at HFHearYourHeart.com/CuideSuCorazonIC.com.

Smriti: Also, tell us how this campaign supports medical professionals and care partners to understand and prioritize heart failure care.

Johanna: Hear Your Heart/Cuide Su Corazón encourages healthcare providers to keep in mind that many aspects of heart failure management are actually done outside of the doctor’s office and complement how we treat the condition in the office. In addition to the clinical care that we provide, we must ensure that our patients are supported personally and culturally so they feel empowered to best care for themselves on a day-to-day basis.

Furthermore, healthcare providers need to take the time to walk through any advice, directions and materials with their patients to make sure they’re fully understood. It is also important for providers to share in-language resources and advice that is tailored to patients’ specific lifestyles and backgrounds. This will help ensure patients have relevant, simple information that they can access and seamlessly apply to their everyday lives. The healthcare community has a responsibility to help close the gaps in care that can lead to worse outcomes, and ensure all patients are accurately guided through their treatment.

Additionally, care partners play a crucial role in the lives of women living with heart failure and it’s important they encourage whomever they are caring for to prioritize their care. Through unique, tailored resources and educational content, including perspectives from women living with heart failure and experts who treat the condition, Hear Your Heart/Cuide Su Corazón provides care partners with the resources they need to ensure they are providing the proper support to the women who do so much for them.

Smriti: Please shed some light on the details (MOA, ROA, formulations, etc) of Jardiance. Also, tell us how SGLT2 as a class has emerged to be an effective treatment for heart failure and beyond (incl. CKD etc.).

Johanna: This is an unbranded educational initiative. It is not associated with any specific treatment. The purpose of Hear Your Heart/Cuide Su Corazón is to encourage women with heart failure, especially Black and Latina women, to prioritize their health and feel confident in asking for the resources they need to feel their best while managing the condition.

Smriti: Can we talk a little more about Jardiance being assessed in CKD indications with diabetes and non-diabetes patients and are there any sub-group analysis relating CKD with HF in both patient groups?

Smriti: It has been quite evident that women fail to receive proper treatment not only for heart diseases but for other diseases as well. How do you look forward to creating more awareness for women globally with other conditions?

Johanna: The hope for Hear Your Heart/Cuide Su Corazón is to help provide support for Black and Latina women living with heart failure, to empower them to feel confident asking for more from their care, yet there is a lot of work to be done to help marginalized communities realize better health outcomes. The Hear Your Heart/Cuide Su Corazón program supports efforts to address health disparity and equity issues that utilize various approaches to ensure the greatest impact. Education and access to the right resources can be an important step forward to help close gaps in care.

Conversation with Lupe

Smriti: Would you please share your experience with our readers?

Lupe: About seven years ago, I visited my primary care doctor and received an EKG test as I had a history of high blood pressure and wasn’t feeling well at the time. The doctor didn’t find anything, but I continued to feel dizzy, only to be told to drink more water. I was always active and would go to the gym until one day I felt like my heart was hitting a wall – almost like it wouldn’t pump anymore. That feeling never really went away, so finally about a year ago, my cardiologist ordered an echocardiogram. We didn’t talk about the results, but when I picked up the medication they prescribed, I saw the words “heart failure” on the package. It was scary, but seeing those words answered seven years of questions in an instant. I gave up my job as a building inspector for a less taxing desk job because of the physical impact of my condition. And although I’ve had to make other changes in this new chapter of life, prioritizing my heart health has helped me to successfully manage my condition.

Smriti: How has the Cuide Su Corazón campaign helped towards the betterment of your disease?

“I want to make sure other women with heart failure understand the importance of asking for support when you need it and putting your own care first, as this is something that I’ve had to adjust to as well”

Lupe: My involvement in Cuide Su Corazón has taught me to lean on my support team, to voice any concerns to my doctors and to adjust my lifestyle, all while staying true to myself and my culture. My heart failure diagnosis is relatively new to me and I am still figuring out how to be my own heart success advocate, but I know that the changes I’ve made so far have made huge differences for me and my family. I want to make sure other women with heart failure understand the importance of asking for support when you need it and putting your own care first, as this is something that I’ve had to adjust to as well.

Smriti: How did you get to know about this campaign?

Lupe: Boehringer Ingelheim and Eli Lilly, who started the initiative, learned about my story and asked if I’d be interested in sharing my experience.

I got involved with the Cuide Su Corazón to show other women, especially Latina women, just how important it is to listen to what your heart needs and prioritize your care. I want others to know and understand that it is possible to continue living your life and planning for the future while managing heart failure.

Smriti: Have you further suggested this campaign to anyone?  

Lupe: Yes, I encourage all women with heart failure to visit HFHearYourHeart.com/CuideSuCorazonIC.com to access additional information about the campaign, as well as resources that provide educational information and tips for managing heart failure.

About Authors:

Dr. Johanna P. Contrera

Dr. Johanna P. Contreras is the Associate Professor at Icahn School of Medicine and Director of the Ambulatory Heart Failure Network and Director of Diversity at Mount Sinai Health System. Dr. Contreras focuses on creating effective treatment programs with the goal of eliminating disparities in heart failure care. She is passionate about promoting diversity and healthcare among minority groups and works to improve their access to advanced heart failure therapies. Dr. Contreras proudly joins Hear Your Heart, empowering Black and Latina women to take control of their heart health, continuing her commitment to increasing visibility and access in the cardiovascular space for minority communities. Dr. Contreras completed her medical education at the Universidad Industrial de Santander and research fellowship program in Molecular Immunology from Harvard University.

Lupe

Lupe is a Santa Rosa, CA resident who was diagnosed with heart failure about a year ago. Following her unexpected diagnosis, Lupe is learning what life with heart failure is really like and how she can achieve heart success. After multiple visits with her primary care doctor and cardiologist over a span of four years, Lupe was diagnosed with heart failure. Reflecting on her ongoing journey, Lupe proudly joins Hear Your Heart to show other women, especially Black and Latina women, how important it is to listen to what their hearts need and take an active role in their heart failure care. Lupe wants to debunk the norm that women suffer in silence by encouraging others to prioritize their own health and ask for support when needed.