With much of our health focus these days on COVID-19 – avoiding it, the vaccination and dealing with friends and family who may contract it – American Heart Month reminds us about the leading cause of death, killing more than 650,000 Americans each year, in the United States: heart disease.[1]
COVID-19 can directly or indirectly impact our heart health, and we will touch on that in this post. We will also talk about the link between our mental health and our heart health, how warning signs of heart disease are different for women, and helpful resources to learn more.
To shed light on these important issues and the latest research, we are pleased to have Rosalind Watman, D.O., Magellan Healthcare’s medical director of cardiology, here with us.
Q: Dr. Watman, can you tell us about the link between our mental health and well-being, and our heart health?
A: Our mental health and heart disease are closely interrelated. Patients with heart disease may suffer from depression at a higher rate than the general population. A contributing factor may be related to the loss of control a person may experience in which they feel limited in what they can do or where they can go. Having heart disease can also make people worry excessively about their health, which can lead to anxiety.
Similarly, people may be more likely to develop heart disease when they experience mental health issues, which are often linked to heart risk factors such as excessive alcohol use, smoking, lack of exercise and poor dietary habits. Other risk factors may be due to the medications used to treat patients with mental health disorders. These medications may be associated with insulin resistance, obesity and an increased risk of diabetes. Because of these factors, people with mental illnesses may have a higher mortality from heart disease.
Q: What can you tell us about how the COVID-19 pandemic has impacted heart health?
A: As COVID-19 cases have risen, people have been hesitant to visit their doctor or the emergency department. As a result, fewer people are getting screened for heart conditions, proper diagnoses and treatment. On average, there has been a 50% drop in the number of people with severe heart attacks coming to the hospital, compared to before the COVID-19 crisis. Of patients who have gone to hospitals, 48%, on average, arrived later than usual and beyond the optimal window for urgent treatment. In the absence of early intervention and treatment, mortality rates for heart disease have increased.
The Centers for Disease Control reported that more than two in five Americans are struggling with mental or behavioral health issues associated with the COVID-19 pandemic.[2] The changing normalcy of our everyday lives, coupled with loneliness and isolation, bereavement, fear, loss of income, and food and housing insecurity are among the factors continuing to impact our mental health, and indirectly, our heart health.
The pandemic has contributed to an increased need for behavioral health services and a lack of access in many cases. Some individuals have been afraid to visit their provider in person, others may lack the technology or know-how for virtual care, and others have experienced a provider shortage and long wait times. When we don’t seek the necessary treatment for our behavioral health concerns, they can manifest in unhealthy ways that have a negative impact on our heart health.
Q: How do women experience the signs of heart problems differently than men?
A: Cardiovascular disease is the number one killer of women aged 65+, causing one in three deaths per year, which is approximately one woman every minute. Women are more likely than men to have atypical heart attack symptoms, so although both can present with chest pain, women who have heart attacks are more likely than men to experience indigestion, back pain and shortness of breath. As a result, women tend to wait longer than men before seeking medical attention for their symptoms, which they may not associate with heart problems. Additionally, women are less likely to be diagnosed as having a heart attack by medical personnel, which may be due to misdiagnosing the atypical symptoms, in some cases to anxiety, and dismissing them.
Q: What are some tips we can use to improve our heart health in these rapidly changing times?
A:
- Exercise for at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week.
- Eat healthy with a diet that includes all major food groups, particularly fruits, vegetables, and whole-grain products. Limit consumption of foods with high-caloric/low nutritional content.
- Limit alcohol and avoid tobacco to help in the management of blood pressure and stress, which can lower the risk for heart disease.
- Rest, allowing your body to reset, and try to get at least 6-8 hours of sleep per night.
- Schedule and keep medical appointments for well visits, immunizations, and annual screenings, and follow up with your doctors as necessary.
Q: How can we learn more and find the best heart health resources?
A: Watch the recording from our webinar, “Take It to Heart,” where I was joined by Santreis Cook, PharmD, Magellan Rx clinical pharmacist, to discuss the connection between heart health and mental health and answer questions.
The American Heart Association website provides a wealth of information, including heart attack and stroke symptoms, COVID-19 resources, and tips for healthy living.
[1] https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
[2] cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm
