Q&A: Growing Links Between Cardiovascular Health and Risk of Complications from COVID-19

Every hour of every day, researchers learn more about the novel coronavirus and how it attacks the body. Alongside significant attention spotlighting the need for more ventilators to help keep patients breathing while they fight the disease, a growing body of knowledge now links COVID-19 and cardiovascular illness, including a heightened risk of COVID-19 patients dying from cardiac arrest.

“Better understanding how the coronavirus may impact the heart may save hundreds of thousands of lives,” said Loni Tabb, PhD, an associate professor in the Dornsife School of Public Health. “Considering the widely documented racial disparities in heart health among other areas exposed by this pandemic, we have a tremendous opportunity to close these gaps, and better direct national resources to communities that need it most in the fight against this devasting pandemic.”

Tabb and colleagues recently published a paper in Journal of the American Heart Association exploring the geographic hotspots of racial disparities in cardiovascular health among blacks and whites across the United States.

As lead author on the research, Tabb shares how better understanding where these concentrations of cardiovascular health problems are may reduce existing racial disparities and improve health for all in the fight against COVID-19. Cardiovascular disease is the number one cause of death in the United States.

A March JAMA study from researchers in China of 416 hospitalized COVID-19 patients found that nearly one in five exhibited heart damage. Also, heart damage significantly increased risk of death. Fifty one percent of patients with heart damage died, compared to only 4.5 percent of COVID patients who did not have heart damage. Is this pandemic a wakeup call for us all to take heart health much more seriously?

I do think this pandemic is a wake-up call for a number of reasons. Ideal cardiovascular health has always been an issue for this country, and with cardiovascular disease being one of the leading causes of death here in the U.S., we as a country need to do better at addressing this public health crisis. With COVID-19, and the related risk factors of contracting the disease and potentially dying from it, the leading risk factors are also critically tied to cardiovascular health: diabetes, heart disease, obesity and smoking.

So much attention has been given to cardiovascular health (CVH) in the so called “stroke belt states,” in the Southeastern United States, but your team found high levels of disparities in CVH in other areas of the United States as well.

Our study looked at the entire U.S. as it relates to racial disparities in CVH – specifically between blacks and whites. While the Stroke Belt is commonly known to have larger incidences of stroke, we also found pockets of the country outside of the Stroke Belt that showed poor CVH and larger disparities in CVH between blacks and whites – some of these areas did include the northeast portion of the country and also near the Great Lakes.

Do your findings parallel with racial disparities in deaths from COVID-19?

While New York has been significantly hit the hardest with COVID-19 related infections and deaths, other states, like Louisiana (which is in the Stroke Belt) and Illinois (in the Great Lakes region of the country) are also among the top states with cases. Policy makers need to take a strong look at the ties of risk factors related to COVID-19, and how these factors are disproportionately impacting racial/ethnic groups across the country, but also, how these factors vary depending on your geographic location in this country. While individual level characteristics matter and impact health outcomes, where you live, work, play and worship all have additional impacts on health outcomes. 

Why did you look broadly at cardiovascular health, including behavioral factors and biological factors contributing to health, as opposed to just looking strictly at cardiovascular disease (CVD)?

Looking broadly at CVH as opposed to the presence or absence of CVD is an advantage in this study. CVH is more encompassing of both biological and behavioral risk factors, which can then be targeted so as to reduce the burden of CVD in this country. The biological risk factors include the following: (1) manage blood pressure; (2) control cholesterol; and (3) reduce blood sugar. The behavioral risk factors include the following: (1) get active, (2) eat better; (3) lose weight; and (4) stop smoking.  

We should all work on these risk factors long after this pandemic ends.

Media Interested in an interview with Tabb should contact Greg Richter at 215-895-2614 or gdr33@drexel.edu.

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