New May 2020 heart health guidelines support lifestyle changes that reduce COVID-19 risk factors: a path for safety after lock down
We are preparing to lift lock down and re-enter our new “coronavirus world”. While it is exciting to leave our homes, we must remember that we are no safer today than we were in March. No medications to date have shown significant prevention or mortality benefit. A vaccine is still years away. In the face of many unknowns and dangers, we need to focus on what we can control in our new COVID world. This is how to stay safe during coronavirus.
There is a high likelihood that we will be exposed to coronavirus in the coming months and years, so what can we do to minimize our chances of developing severe disease? It starts with lifestyle and heart health.
What we know for certain
We are certain about a key element: how we can reduce COVID-19 risk factors. We are now all familiar with hand hygiene and mask usage, so I want to move past that.
Data from across the world has consistently shown over representation of several diseases in hospitalized COVID-19 patients:
- High blood pressure
This association suggests that people without these comorbidities are less likely to be hospitalized from COVID-19. This valuable knowledge can help us stay safe during coronavirus because we can control these comorbidities.
Hospitalization risk matters in staying safe during coronavirus
Hospitalization for COVID-19 predicts bad outcome. Mortality rate varies from 15-25% for patients hospitalized with COVID-19. This even includes those not on ventilators.
Since we are very likely to get exposed to coronavirus in the coming years, we want our body defenses to be “strong enough” to prevent severe disease if (or when) that happens.
Let’s start with cardiovascular risk
Heart disease is the number one cause of death worldwide. It is also one of the most preventable with lifestyle changes. Heart disease also appears to play a large role in COVID-19. This is where we suspect high blood pressure, diabetes, and obesity are involved. They may offer clues on how to stay safe during coronavirus.
Fortunately, cardiovascular disease is so amenable to lifestyle modification that lifestyle counseling alone can reduce the chance of heart attacks and strokes! Our latest May 2020 heart health guidelines emphasize the importance of lifestyle discussion to reduce risk factors (summary at end of post). No medications or expensive treatments, just discussing healthy lifestyle choices. There are no appreciable side effects (and it’s cheap!).
Why do we think cardiovascular risk contributes to COVID-19?
We don’t know for sure, but there are many reasons why cardiovascular disease likely contributes to severe COVID-19 infection:
- COVID-19 can result in heart muscle injury. Patients with weakened or diseased hearts may have “less reserve” to compensate for heart injury in COVID-19.
- High blood pressure, diabetes, and obesity all contribute to heart injury (what we call “ischemic heart disease”).
- Damage by COVID-19 to an already diseased heart may overwhelm the heart’s ability to compensate.
- Cardiovascular disease is associated with chronic inflammation.
- Diabetes and obesity are key drivers of chronic inflammation.
- COVID-19 can activate acute inflammation as seen through “cytokine storm”, “ARDS”, and blood clots. There may be a causal link here.
- Chronic inflammation (such as from cardiovascular disease) can also weaken the immune system.
- Diabetes is well known to increase the risk of infection.
- Medications used to treat common cardiovascular conditions may interfere with disease severity. Fortunately, this appears less likely than originally thought.
What can you do today to minimize your risk of severe COVID-19? How do you stay safe during coronavirus?
So how do you stay safe during coronavirus? We need to build on simple hand washing and masks by finding our COVID-19 risk factors and reducing them with our lifestyle choices.
There is a lot you can do – and it involves small lifestyle changes that are done consistently. I want to start by sharing a new study on olive oil and how a simple daily ingredient swap can reduce your risk of heart disease and stroke.. and possibly severe COVID-19 infection.
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The information provided in this post in intended for general education. It is not medical advice. While I make every effort to provide the most up-to-date information, please note that new data is continuously becoming available and may change the conclusions I present here.
Brief summary from May 2020 guidelines
While lifestyle modification should be a highly personalized set of recommendations, I wanted to share the general guidelines for reference:
Common dietary counseling advice includes reductions in saturated fats, sodium, and sweets/sugars, and increased consumption of fruits, vegetables, and whole grains. The Dietary Approaches to Stop Hypertension (DASH) diet, low-sodium diet, and the Mediterranean diet are commonly recommended diets. Physical activity counseling focuses on patients achieving 90 to 180 minutes per week of moderate to vigorous activity (reference)
Lifestyle modifications to stay safe during coronavirus? Lifestyle modifications need to match your life!
Lifestyle counseling is most effective when it is tailored to your life. Not the average person out there, but your life. It has to account for your preferences, your job, your family, etc. There is no one-size-fits-all approach. Just consider how our lifestyles differ in so many ways:
- Our environments are incredibly different.
- Think of your home, workplace, commute, etc.
- Your mental health and coping mechanisms are unique to you.
- Your stresses in daily life are also unique to you.
- Your pre-existing medical conditions are different than your neighbors’.
- What you like to eat determines what you eat.
- When and how you sleep is particular to you.
Stay tuned for more strategies to find the lifestyle modifications that can keep you safe during COVID-19 and after!