• By Terri Malloy

Expert Alert: Have heart disease? Protect your health during the COVID-19 pandemic

March 25, 2020
a blood pressure cuff and gauge, with a red plastic valentine heart

ROCHESTER, Minn. ― People with heart disease and other underlying health conditions are at a high risk for becoming seriously ill if they develop COVID-19. Heart patients may question if they are doing the right things for their health at a time when there is little research available surrounding this new viral disease. Stephen Kopecky, M.D., a Mayo Clinic cardiologist, talks about what heart patients need to consider in relation to COVID-19.

Flu shots important to head off viral inflammation

"One of the most important precautionary steps for a person with heart disease is to have the influenza vaccine," says Dr. Kopecky. "Research shows that people vaccinated for the flu reduced their risk of having a heart attack or stroke by about 50% during that flu season."

While the flu shot won't prevent COVID-19, it can prevent influenza or at least reduce the severity of the flu. And when fewer people contract and spread the flu, it means fewer patients who need to be treated and more medical resources available right now for COVID-19.

Dr. Kopecky says that the influenza virus is dangerous for heart patients because it can cause an inflammatory reaction all over the body, and the inflammation can irritate the lining of the arteries. If those arteries are already strained with plaque buildup, the inflammation can lead to a tear. A blood clot could form, blocking blood flow to your heart or brain causing a heart attack or stroke.

"Other respiratory viruses have a similar effect. Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, is the virus that causes COVID-19. It can increase bodywide inflammation just like the flu, and if you have heart disease, it can be a double problem if you get a SARS-CoV-2 infection," says Dr. Kopecky.

Medications

Considering the current need for social isolation to limit the spread of COVID-19, it is a good idea to check your supply of prescriptions and stock a month's supply now. Heart patients should not disrupt their medication schedule, unless directed to do so by their health care provider.

"If you are over age 75, then stopping a statin increases your risk for having to go into the hospital for a cardiac event by approximately one-third. Therefore, it is very important to continue statin use so you can stay away from hospitals," says Dr. Kopecky.

He adds that the same is true for beta blockers. Do not skip doses. Patients who are taking an angiotensin-converting enzyme, or ACE, inhibitor or angiotensin receptor blocker should not stop treatment, unless told to do so by their health care provider.

"Taking a nonsteroidal anti-inflammatory drug, or NSAID, is common in the flu season, but will increase your risk of a heart event within seven days of taking it daily. That is true for all NSAIDs, except naproxen, which can be taken for 30 days daily before increasing risk for a heart event. The best option is to take acetaminophen, which does not increase your risk of a heart event," says Dr. Kopecky.

Maintain healthy diet, weight

Keeping weight gain in check during stressful times is important, especially for heart patients. If you have heart failure, weigh yourself daily at the same time, on the same scale, with the same amount of clothes on or off. Some people find it easiest to do this in the morning when they first get up.

"Try to keep your weight stable, especially since you may be eating meals that have extra salt in them during this difficult time," says Dr. Kopecky.

Regarding healthy weight, Dr. Kopecky says there are four A's that people need to be worried about in a modern diet:

  1. Addictive food
    Addictive foods, including processed foods such as chips and store-bought cookies, provide a surge of energy from the fat and the sugar they contain, and create the urge to eat them again.

  2. Add-on calories
    Add-on calories often come in the form of sugary drinks and alcohol, so heart patients need to pay attention to what they drink and what they eat.

  3. Automatic food
    These are foods that people eat without thinking, such as the bread, or chips and salsa, served before a meal.

  4. Adulterated food
    These foods look better than they are because of the chemicals and processing used to produce them. Adulterated foods are not healthy additions.

Keep up the exercise

Dr. Kopecky suggests that patients continue with their recommended exercise routines if they do not have symptoms of COVID-19. Besides providing the comfort of keeping a routine, regular exercise helps relieve stress and maintain weight. He cautions that eating more without exercising will cause weight gain.

"It's better to recognize weight gain on your scale early on, before it starts to cause symptoms which lead to shortness of breath and the need to be seen by your doctor, or to go to the emergency room," says Dr. Kopecky. "Remember, do all you can to stay away from hospitals during this pandemic, especially if you have a heart condition."

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