Over the initial two years of the COVID-19 pandemic, spanning from March 2020 to March 2022, the United States witnessed an unexpected increase of approximately 90,000 deaths attributed to cardiovascular disease. These fatalities were primarily observed in individuals aged 65 and older, who are inherently more susceptible to cardiovascular complications. However, a startling surge in heart-related deaths was also noted among younger adults, specifically in the 25- to 44-year-old age group, according to a study.
While some of these cardiovascular-related deaths may be attributed to limited access to medical care during the pandemic’s peak, there is mounting evidence that COVID-19 itself played a significant role. In addition to acute-phase complications, individuals who had contracted COVID-19 faced an elevated risk of heart attacks, strokes, and other cardiac issues for up to a year after their infection. The medical community is now grappling with the critical question of why this connection exists.
Dr. Susan Cheng, Chair of Cardiovascular Health and Population Science at Cedars-Sinai, who led the study on heart attack deaths, acknowledged the existence of a unique link between the virus and the cardiovascular system. However, uncovering the precise nature of this connection remains an ongoing challenge.
Immediate Impact on the Heart
Cardiologists have posited that COVID-19 inflicts damage on the heart and triggers cardiovascular events primarily through the induction of widespread inflammation. Inflammation is a known contributor to increased cardiovascular risk, and severe COVID-19 infections are known to stimulate inflammation. This inflammation can lead to the rupture of arterial plaques, forming blood clots and potentially causing heart attacks or strokes in individuals with preexisting plaque buildup. Therefore, those who already have plaque in their arteries, such as smokers and individuals with high blood pressure and cholesterol, face a heightened risk of COVID-19-induced heart attacks.
Furthermore, in certain cases, inflammation within blood vessels can provoke spontaneous clot formation, even in individuals without preexisting plaque. This phenomenon explains how young individuals with no history of plaque can experience heart attacks under specific conditions.
Long-Term Effects on the Heart
The risk of cardiovascular complications does not dissipate once a person recovers from COVID-19. A large-scale 2022 study of 691,455 patients in the United States revealed that individuals had a significantly elevated risk of developing various heart-related diseases within a year following a COVID-19 infection. This risk included a 1.5-fold increase in the likelihood of experiencing a stroke, nearly double the risk of having a heart attack, and a 1.6 to 2.4 times higher risk of developing different types of arrhythmias.
Some of these conditions may result from the lingering effects of the infection, while others might emerge due to the onset of risk factors for heart disease, particularly hypertension. Research indicates that approximately 21% of individuals hospitalized for COVID-19 and nearly 11% of those with milder infections but no hospitalization went on to develop high blood pressure in the months following their illness.
Role of Vaccines in Reducing Risk
Studies have demonstrated that vaccinated individuals have a 40% to 60% lower likelihood of experiencing a heart attack or stroke after contracting COVID-19 compared to those who are unvaccinated. This reduction in risk may be attributed to lower rates of severe COVID-19 in vaccinated individuals, subsequently diminishing the risk of heart-related issues. Alternatively, vaccines may protect the cardiovascular system itself by mitigating the inflammatory effects of COVID-19.
It is worth noting that while there is a small risk of developing myocarditis (inflammation of the heart muscle) after receiving mRNA COVID-19 vaccines from Pfizer-BioNTech or Moderna, the risk of myocarditis following COVID-19 infection is significantly higher. Research by the Centers for Disease Control and Prevention revealed that males aged 12 to 29, who are at greater risk of vaccine-related complications, were four to eight times more likely to develop myocarditis following a COVID-19 infection than in the three weeks after receiving a vaccine dose. For males aged 30 and older, the risk of myocarditis from COVID-19 exceeded that from the vaccine by 28 times.
Managing Your Risk
Individuals who have recently had COVID-19 and experience cardiovascular symptoms, such as chest pain or shortness of breath, or those at an elevated risk for heart disease, should promptly contact their healthcare provider. Vigilance in monitoring blood pressure and cholesterol control is essential.
For those without risk factors or symptoms, informing your doctor of a COVID-19 infection during your next annual checkup is advisable. In the meantime, adopting heart-healthy habits such as regular exercise and a balanced diet can contribute to minimizing cardiovascular risk.