COVID-19 and your heart

AT THE start of the coronavirus pandemic, about 2.5 million women lost their jobs or dropped out of the workforce, but that is just the start of the impact from the pandemic on women.

Unfortunately, research has already started seeing evidence of the long-term impact of COVID-19 on women’s hearts. The impact of stress and lack of self-care that women have had to endure have heightened the risk of heart disease, which is already the number one killer of women.

COVID-19 is not just a disease of the lung. It uniquely attacks the heart and can also put one at risk of severe illness. Women who are at risk for heart disease should pay attention to their mental health, as they are twice as likely as men to develop depression, and depression is a risk factor for heart disease.

Women are also at a higher risk than men for life-threatening outcomes after cardiac events. Knowing the symptoms of heart disease can help, especially in deciding when to seek medical care; and knowing the symptoms of depression is also helpful, even though they may get less attention at first. Often, the many physical symptoms of heart disease may overshadow mental signs of depression.

While the exact relationship between depression and heart disease is still being studied, enough is known to raise awareness about the dangers of this condition on heart health. Research shows that even mild forms of depression or its symptoms increase the chance of heart disease in women by two to three times.

GREATER RISK

Women are at greater risk for depression than men for a variety of reasons, including certain biological, hormonal and social factors that are unique to women.

Research shows that people with depression are more likely to have poor heart health. A study by the American Heart Association found that depression could be a barrier to living a heart-healthy lifestyle.

With the onset of the coronavirus pandemic, research has shown that COVID-19 uniquely attacks the lining of our blood vessels, which in medical terms is called the endothelium. The endothelium is the lining of the artery. It is the part of our arteries that protects against atherosclerosis and the build-up of plaque.

It is the first thing that is affected when the arteries get stiff at the time that high blood pressure, high cholesterol, stress, anxiety and depression, elevated sugars and menopause happens. Microvascular disease, which is the smaller arteries that are often affected, are due to the damage to the endothelium.

Women’s arteries are different from men. In men, the artery disease typically develops in a single and obvious spot. In women, artery disease is diffused, with many little tears in many places, which is anything but obvious. It is highly likely that these tears were there prior to the virus, and getting the virus will only exacerbate the tissues.

Also, in recent research published by the John Hopkins University, some of the symptoms of depression make it challenging for women to take care of themselves and make healthy choices.

The report, ‘Women –How COVID-19 Is A Threat To Your Heart?’, said that often, women with depression sleep too much or not enough, feel fatigued, have little interest in doing things, and lack energy. None of which, it said, are conducive to sticking with a healthy diet or cardiovascular exercise programme.

Women may try to deal with their depression through comforting but harmful behaviours, such as smoking, drinking alcohol or overeating. In fact, women with high levels of depression are more likely to be obese or smoke.

In addition, depression and the feelings that often accompany it, such as anxiety, anger, stress and loneliness, can trigger physiological changes in the body that increase the risk to the heart.

When a person is feeling stressed, the body releases more of the stress hormone cortisol, which has been linked with an increased risk of heart disease and heart attacks.

Overall, many people who are also diagnosed with heart disease are at risk of developing depression. Studies show that up to one-third of heart attack patients develop some degree of depression, according to the American Heart Association.

In 2016, the United States Preventive Services Task Force recommended depression screening for the general population, with an emphasis on people with heart disease.

With research and expanding clinical experience, doctors are learning more about the relationship between depression and heart disease, including the role depression plays before and after a heart attack or other cardiac problems, particularly in women.

With the psychological and economic toll of the pandemic on women, including stress and depression, doctors and researchers are encouraging people with certain underlying conditions, including depression, to take extra caution to avoid exposure to the virus while it remains a public health threat.

Women living with, or at risk of, heart disease should also take steps to manage their condition and stay safe.

keisha.hill@gleanerjm.com

SOURCES: John Hopkins University, American Heart Association, Centre for Disease Control and Prevention