What You Should Know About Heart Disease and COVID-19

We spoke with Andrew M. Freeman, M.D., FACC, FACP, about how those living with heart disease can protect themselves against COVID-19.

If you are a person living with heart disease, you are considered at higher risk for experiencing complications associated with COVID-19, along with elderly populations and those living with other chronic conditions, such as diabetes (if you have diabetes, here's what you should know about COVID-19). This is not a cause for panic, however, as there are several key ways to prevent and prepare. We spoke with Andrew M. Freeman, M.D., FACC, FACP, co-chair of the American College of Cardiology Nutrition and Lifestyle Work Group, to learn more.

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Heart Disease and COVID-19

People living with heart disease are considered a higher-risk population for getting very sick from COVID-19, but that doesn't mean they have a higher chance of contracting the virus itself.

"COVID-19 puts an enormous amount of demand on one's body and could cause you to develop heart attacks or similar effects," Freeman says.

The American College of Cardiology says acute viral infections such as COVID-19 have three types of temporal effects on the cardiovascular system:

  • Increased risk of acute coronary syndromes associated with the severe inflammatory response to the infection.
  • Myocardial depression leading to heart failure.
  • Under-recognized risk of arrhythmias, also related to acute inflammation.

Those with heart disease are also at higher risk for influenza complications, and health experts are applying their knowledge of the flu to help patients with heart disease prevent and prepare for COVID-19.

How to Prevent and Prepare for COVID-19

"The best way to keep away from COVID-19 is to stay home," Freeman says."If you have a heart condition—especially if you're over 60—stay home and stay away from people to the best of your ability. Practice proper hand-washing and be sure to disinfect hard surfaces like doorknobs."

Additionally, if people living with heart disease do not have access to medication, healthy foods and medical supplies, it could be difficult to remain healthy. Freeman advises maintaining your supply of medications and any other over-the-counter drugs you may need (like aspirin). He says you should have enough for two to four weeks at a time. Not all insurance plans will cover it, but it's worth calling to ask your doctor about getting a three-month prescription instead of a one-month or looking into getting your prescription mailed to you.

The CDC recommends higher-risk populations stay up to date with COVID-19 vaccines and wear a mask in public indoor spaces like grocery stores, especially if you are in an area with a high COVID-19 Community Level. Many processed and shelf-stable foods are viewed as unhealthy but there are lots of healthy options. Make sure you have fruits and vegetables on hand—fresh, frozen, dried or canned work. Whole grains, such as whole-wheat pasta, oatmeal and quinoa, and beans and olive oil are other healthy pantry staples. You can buy canned fish or frozen fish to have on hand for easy meals. Healthy meals don't have to be complicated and can come from your pantry and freezer.

"Eating healthy and practicing self-care is one of the best ways to stay healthy, Freeman says. "Try to exercise at home, in your neighborhood or at your favorite park early in the morning when there are likely to be fewer people around. Stay away from fitness studios or gyms, but don't stay away from exercise."

Besides eating healthy and exercising regularly, Freeman also says managing stress and getting enough sleep are important for prevention. He says you should aim for seven hours of uninterrupted sleep and step away from the screens if you're feeling stressed.

"Stress makes the immune system less strong," Freeman says. "Part of self-care is reminding yourself you are doing your best and you can't let the stress of it all get to you."

What to Do If You Get Sick

Following CDC protocol for what to do if you contract COVID-19 will protect you and help prevent further spread of the virus. If you think you have been exposed to COVID-19, call your doctor. Common symptoms include fever, cough and shortness of breath.

Freeman says the best thing to do if you get sick is to weather it out at home and try to remain in isolation. You should seek immediate medical attention if you are experiencing difficulty breathing, bluish lips or face, persistent pain or pressure in the chest, new confusion or the inability to wake or stay awake. The CDC recommends calling 911 or your local emergency facility before you come in to let them know you're seeking care for someone who has or may have COVID-19.

The Bottom Line

The threat of COVID-19 should not be a cause for panic but rather for practicing preparedness, proper hygiene and other preventive measures. Talk to your health care providers about any concerns you may have, and take breaks from social media or news if you start to become anxious.

"Patients who see me if it's their time of the year to check in should postpone, but if someone is coming in for high blood pressure, angina or have urgent needs and are well enough to travel, I'm going to do my best as long as I am able," Freeman says. "If you can't travel or don't feel it's in your best interest, then you should hold off on coming in." If available, telehealth visits or talking to your health care provider over the phone is a convenient and safe option.

"Even though COVID-19 is lethal to select populations and still contagious, cardiovascular disease is still the leading killer of Americans," Freeman says. "This is not the time to start living on Cheez Doodles simply because they are shelf-stable." A 2023 study published in the Journal of Medical Virology found that the rise in acute myocardial infarction (AMI) associated deaths in the U.S. during the pandemic had the greatest impact on younger adults (25 to 44 years old), as this group saw the greatest relative increase in excess AMI-associated mortality. Before the pandemic, rates of AMI-associated deaths had been decreasing overall, which further reinforces recommendations for extra precautions if you are a person living with heart disease.

Stay home, stay safe and talk to your doctor if you have specific questions.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While EatingWell is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO and their local public health department as resources.

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