There is a growing concern among health-care professionals and researchers that patients with heart disease are delaying treatment and hospital visits due to COVID-19 fears. When they finally seek medical assistance, it may be after their condition has worsened and treatment is less likely to be lifesaving.
Recent research shows that there is a 50 to 60 per cent decrease in the number of patients visiting hospitals and clinics with heart concerns in Canada. Typically, there's about a 10-per-cent fluctuation of cardiac cases annually, which makes this particularly concerning as we know that heart attacks and strokes are still occurring, but patients are reluctant to come forward.
Studies suggest that recent respiratory infections can double the risk of a heart attack or stroke; any rise in heart attacks or strokes should have occurred by now as COVID-19 case counts continue to mount. More importantly, people with coronary artery disease or risk factors for atherosclerotic disease, like high blood pressure have a heightened risk of developing an acute coronary syndrome (heart attack) during acute infections. Heart disease is the number one killer of Canadians, which makes this worrisome for Canadians, but even more so for women.
Despite a global understanding that the presentation, treatments and outcomes of cardiovascular diseases are known to be different between men and women, women continue to be under-diagnosed, under-treated, under-supported and under-researched. According to the Heart and Stroke Foundation of Canada, two-thirds of research into heart disease and stroke is based on cases involving men.
Five times as many women die from heart disease than from breast cancer. More importantly, women are under-aware that cardiovascular disease is the leading cause of premature death for women in Canada, and we expect the numbers of cardiac issues in women to rise amidst the pandemic.
Why? For many women-particularly those with children or elders at home-the coronavirus pandemic has given new urgency to many of the challenges that they have long been confronting, such as balancing multiple responsibilities, working without a safety net (paid sick leave or family leave), suffering from lack of short- and long-term care support and experiencing increasing levels of stress and anxiety.
We also know in times of stress the risk of heart attacks and strokes increases. Anxiety, frustration and depression-emotions exacerbated by the pandemic-are all linked with a heightened heart-attack risk. Through research, we know that women are more likely to worry about the negative consequences of coronavirus and more women report feeling negative mental health effects from worry over the virus.
Finally, we know that COVID-19 can affect the heart, which should be increasing the number of patients with heart problems-especially women, given the influence of existing sex and gender disparities that impact heart-disease recognition and outcomes.
There are various gender-related factors and differences that come into play when discussing how heart disease differs from men and women; however, the overall message is clear regardless of sex and gender: don't delay critical treatment. Time is of the essence when it comes to treating heart attacks and strokes; the deaths that occur may not be a direct result of COVID-19, but it's surely an indirect result of the pandemic.
Heart condition patients still are and will always be a priority for health-care professionals, and hospitals are prepared and equipped to care not only for patients with COVID-19, but for anyone with life-threatening conditions.
There's no time like the present for women to stand up and advocate for their heart health. We are all worried about COVID-19, but that means now, more than ever, we should be focused on our health. If you have symptoms of a heart event or stroke (chest discomfort, shortness of breath, or other cardiac symptoms), call 911 immediately; hospitals are safe and ready to care for you.
Together, we can minimize the adverse health effects of the pandemic by seeking medical attention for critical, yet treatable, conditions like heart attacks and strokes.
Colleen Norris is a researcher and educator at the University of Alberta, scientific director for the Cardiovascular Health and Stroke Strategic Clinical Network and working group chair of the Canadian Women's Heart Health Alliance.
This opinion-editorial originally appeared April 28 in the Edmonton Journal.