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According to the American Heart Association, about one in three people with COVID-19 has cardiovascular disease, making it the most common underlying health condition. COVID-19 patients with underlying conditions are six times more likely to be hospitalized and 12 times more likely to die than patients without any chronic health problems. Nearly half of adults in the United States—more than 121 million people—have some type of cardiovascular disease. It is the leading cause of death among men and women in the United States; nearly 650,000 die from it every year. Yet heart disease is preventable 80 percent of the time.
Mount Sinai cardiologists say many patients are exercising less during the pandemic. Some are afraid of going outside and potentially exposing themselves to people who may have COVID-19. As a result, a subset of patients have run out of medication, putting them at risk of cardiac complications. Nutrition has become an issue as well: some cardiologists say 25 percent of their patients have gained up to 20 pounds because they’re not eating a healthy diet. A decline in mental health is also a contributing factor for worse eating habits and being less active.
“It is critical to stay physically fit and in your best personal health to combat heart disease, COVID-19 infection and the post-COVID effects. We tell our patients that participating in home-exercise programs, taking a short walk, dancing, stretching, and even house cleaning will get them moving and make a difference. Keeping a good mental outlook is also key and it’s important for people to find ways to ensure that this happens by staying active, meditating, or simply doing things that make them happy,” says Icilma Fergus, MD, Director of Cardiovascular Disparities at The Mount Sinai Hospital. “During this pandemic some patients have expressed they’re dealing with stress, anxiety, insomnia, and depression. We discuss techniques to improve their mental and emotional wellness, which carries over to their cardiovascular health.”
COVID-19’s Impact on the Heart and Recovery
COVID-19 can cause an inflammatory response in the body, along with clotting that can impact the heart and how it functions. Mount Sinai researchers discovered that some hospitalized COVID-19 patients have structural damage after cardiac injury that can be associated with deadly conditions including heart attack, pulmonary embolism, heart failure, and myocarditis, or inflammation of the heart.
Non-hospitalized COVID-19 patients can also experience complications including heart rhythm disorders, hypertension, myocarditis, and chest pain that feels similar to a heart attack. Cardiologists say it’s important for COVID-19 survivors—even without cardiac symptoms—to have a heart exam two to three weeks after recovery, as there could be residual effects that may go undetected and lead to future health problems.
“For anyone who developed heart issues post-COVID-19, exercise should be delayed two to three weeks after resolution of symptoms including chest pain, palpitations, and shortness of breath. Remember to ‘go slow’ as recovery from this illness is not a sprint; it is a marathon,” explains Maryann McLaughlin, MD, Director of Cardiovascular Health and Wellness at Mount Sinai Heart. “Anyone who has been diagnosed with myocarditis needs to be under a physician’s direction when deciding to exercise, and competitive athletes may need three months to recover from the illness before returning to full routine.”
Recovered COVID-19 patients with a history of heart attack, coronary artery disease, or cardiac stents, should get a monitored stress test before getting back to a full workout. Anyone who had chest pain while sick with COVID-19 should talk to their doctor about evaluation with an echocardiogram or other cardiac imaging.
High-Risk Groups and COVID-19 Vaccinations
Everyone is at risk of heart disease, but people are more susceptible to getting the disease if they have cardiovascular risk factors including high cholesterol, high blood pressure, being overweight, and using tobacco. Age is also a factor, specifically for women over 65 and men older than 55, along with those with a family history of heart disease and people who sleep less than six hours a night.
Certain minority groups including African Americans and Latinos are also at higher risk due to genetic predisposition, diet, lifestyle factors, and socio-economic factors. However, illness in any population can be prevented by taking simple steps towards a healthier lifestyle.
Mount Sinai cardiologists encourage those in these high-risk groups to get a COVID-19 vaccine when they qualify under state distribution guidelines.
“We have noticed some patients in these high-risk minority groups have been reluctant to get vaccinated, fearing it’s not safe. What is important for them to understand is that tremendous scientific advancements have led to the safe development of COVID-19 vaccines and we are encouraging them to get vaccinated,” says Johanna Contreras, MD, Director of Heart Failure and Transplantation at Mount Sinai Morningside.
Tips for Lowering Heart Disease Risk
- Know your family history
- Be aware of five key numbers cited by the American Heart Association: blood pressure, total cholesterol, HDL (or “good”) cholesterol, body mass index, and fasting glucose levels
- Maintain a healthy diet, eating nutrient-rich food and eliminating sweets
- Limit alcohol consumption to no more than one drink per day
- Quit smoking
- Watch your weight and exercise regularly
- Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in arms, back, neck, or jaw; breaking out in a cold sweat; and lightheadedness
About the Mount Sinai Health System
The Mount Sinai Health System is New York City’s largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care—from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. Mount Sinai Heart at The Mount Sinai Hospital is the nation’s No. 6-ranked heart center, and The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report’s “Honor Roll” of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty and our physicians in the top 1% of all physicians nationally by U.S. News & World Report.
For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.
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