Even beyond the disease, COVID has affected our heart health

Our hearts have a big job to do. Despite their impressive task of keeping us alive every second of every day, they too have felt the effects of the COVID-19 pandemic. Perhaps they were damaged by the disease itself or indirectly affected by the way we had to change our lives and habits.

A little more than two years after the World Health Organization declared the global pandemic of COVID-19, researchers are still working to discover the meaning of the cascading action of the respiratory virus through the body. Scientists are also seeing other, less direct impacts of COVID-19. Stress, lifestyle changes, heavy drinking and barriers to access to health care — in addition to the disease itself — affect people’s heart health and lead to an increase in heart disease.

Heart disease describes more than a sudden heart attack – it’s a broad term for several conditions that affect the way the heart works, and can go hand-in-hand with other common health conditions, including diabetes. High blood pressure is a major risk factor for heart disease.

Although heart disease remains the leading cause of death worldwide, modern treatments and prevention efforts have led to a steady decline in the number of deaths over the past few decades. Now a pandemic is threatening progress in heart health. When adjusted for age, death rates from heart disease and stroke increased from 2019 to 2020 in the US, according to a study published in late March. The increase was greatest for black Americans, who had a fivefold increase compared to whites.

The disease COVID-19, which attacks the heart, blood vessels and other key parts of the body, is responsible for some cases of heart disease and damage. But everyday factors that affect or impair our health, including scheduling or other social determinants of health, also likely played a role in the increased mortality seen in the study, says Dr. Amy Pollak, a cardiologist at the Mayo Clinic.

“Most of my patients have had a significant change in how much they exercise or a change in their diet at some point in the last two years,” says Pollak. “And that can affect our blood pressure, blood sugar, and cholesterol—as well as just changes in activity that affect our health and stress levels.”

According to a February survey by the Cleveland Clinic, 40% of Americans have experienced at least one heart-related problem since the start of the pandemic, including things like shortness of breath or high blood pressure.

Here’s how the pandemic captured the heart.

How stress and social isolation hurt the heart

Stress releases cortisol, a hormone that can increase cholesterol over time. blood sugarblood pressure and triglycerides – all of which can increase the risk of heart disease.

For better or for worse (mostly for worse), our body follows stress. As we move into the third year of the pandemic, most people have experienced some degree of stress stemming from loss, grief, boredom, complacency or other emotions. While our collective mental health has plummeted, the pandemic has also contributed to an increase in everyday stressors in some people’s lives that may be less dramatic and harder to pin down, such as homeschooling, job changes, or the fear of getting sick.

Stress can also sap your energy and leave you feeling tired, which can lead to other factors that negatively affect heart health, such as overeating, lack of exercise, and not taking medications as prescribed. Inactivity (which is common among people who are stuck at home, or two years away from their favorite exercise group or gym) increases the risk of coronary artery disease, or buildup in the blood vessels that supply blood and oxygen to the whole body.

Social isolation and loneliness have also characterized much of the COVID-19 pandemic, with older people bearing much of the burden even before COVID-19. A study on heart disease risk, social isolation and loneliness found that postmenopausal women who experienced both were 27% more likely to develop heart disease than their peers. Although the study was conducted before the pandemic, Pollak fears that the effects will be even more pronounced now. And it’s also harder to describe from a medical standpoint.

“We don’t understand the ‘why’ so much,” says Dr. Pollak. “How much of that is related to, if you feel socially isolated, do you also have changes in your physical activity or diet. Or are you less likely to make those positive choices to monitor your blood pressure?”

But the role of chronic stress and the toxic effect that too much cortisol has on our bodies probably has a lot to do with people’s experiences of social isolation.

“We know that chronic stress, separate from diet and lifestyle, is independently associated with a higher risk of heart attack or stroke,” says Pollak.

Stress, loneliness or other emotions can also make us reach for the bottle. About a quarter of Americans said they are drinking more to cope with the stress of the pandemic, combining another cultural shift in our views on alcohol with potentially negative consequences for heart health.

dr. Arun Sridhar is a cardiologist and assistant professor of cardiology at the University of Washington School of Medicine. He sees increased alcohol consumption as increasing the risk of atrial fibrillation — an irregular, often rapid heartbeat — which is one of the most common types of arrhythmia (irregular heartbeat).

“We have seen an increase in patients with atrial fibrillation and cardiac arrhythmias,” says Sridhar. But he can’t say for sure that all of these cases are a direct result of alcohol, because there are factors other than heavy drinkers at play — including people who don’t come to follow-up care because of existing heart disease or delay care all together.

“All these things have increased the number of patients coming in for arrhythmia treatment these days,” says Sridhar.

The heart of delayed care

As hospital capacity has reached its limits in various places in recent years and emergency appointments have been canceled, the inability to get to a blood pressure check or other primary care check-up is also taking its toll on American hearts.

Sridhar says he is concerned about health care delays due to what he calls “long-term maintenance issues.” A major cardiac event, such as a heart attack or even palpitations, is usually significant enough to seek help and care, he says. But when it came to managing high blood pressure, diabetes or other direct risk factors for heart disease, patients did not seek care, either for fear of cost or hospital exposure.

But patients may not need to come in to check their blood pressure, as long as they have the right tools at home. Some research from the UK suggests that patients who are fitted with a blood pressure monitor and work with their healthcare team via medication consultation videos and education may be able to manage their hypertension more effectively.

The barrier to this type of telemedicine care for more people is, of course, the devices. Patients must be connected to whatever video system their provider requires, and blood pressure monitor (which can cost you anywhere from $30 to $200) and someone to help you set it up, if needed.

How long does COVID affect the heart?

Some people who have recovered from COVID-19 are yet to feel like their old self, burdened by lingering symptoms that interfere with their daily lives. For people living with long covidanswers about its cause and potential treatments remain in limbo as new symptoms are added to the extensive list almost daily.

Arrhythmia, or abnormalities in your heartbeat, is one symptom of long-term COVID. Another is the feeling of shortness of breath that some people easily do something that, before the infection, would not have been an effort for them. This shortness of breath is caused by changes in the heart’s capacity to “increase output,” says Sridhar, or changes in the amount of energy we can put forth.

A major study published last month in the journal Nature outlined the broad effects of COVID-19 on heart health. The study analyzed data from millions of medical records in the US Department of Veterans Affairs database. Not only can COVID-19 affect heart vessels and damage muscles when people are acutely ill, but even 30 days after infection, people were at higher risk of various types of cardiovascular disease, including cerebrovascular disorders, arrhythmias, ischemic and non-ischemic heart disease. pericarditis, myocarditis, heart failure and thromboembolic disease.

“If anyone ever thought that COVID-10 was like the flu, this should be one of the most powerful sets of data to show that it’s not,” Dr. Eric Topol, a cardiologist at Scripps Research, told Science.

The heart is one of the most important organs in our body (perhaps the second the brain). Given the indispensable role it plays in our ability to sustain life, even small disruptions in the way its systems function can affect everyday life. More research and time is needed to measure the full impact of COVID-19 on the heart.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health care professional with any questions you may have about your health condition or health goals.