“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
Climate change has contributed to hotter summers and colder winters. The latter is of special concern because deaths increase during winter months. An obvious explanation is the stress of cold temperatures, but shorter daylight hours, inactivity, increases in respiratory illnesses, binge eating and drinking, and other lifestyle changes are among the possibilities.
The COVID-19 pandemic has added to winter’s stress.
Recent estimates indicate that about 3.4 million deaths occurred in 2020 in the U.S. Compared with 2019, this represents an increase of about half a million total deaths (17.7 percent). COVID-19 was the third leading cause of death (about 350,000), behind heart disease and cancer, and the main cause for the increase.
Other ailments such as heart disease, Alzheimer disease, and diabetes have added to the increased mortality, leading to reduced life expectancy at birth by about a year, and two years for the African American population. While healthy lifestyle habits can mitigate such reductions, mortality trends still showed seasonality, with the number of deaths higher in the winter.
As a cardiologist, the increase in heart disease deaths during COVID-19 has raised my concern. Some of those deaths may be explained by patients reluctant to seek medical help, either prior to an event or during an acute illness, because of fear of contracting COVID-19.
However, we now know that inflammation plays a critical role in the development of atherosclerosis, and the heart attacks and strokes that follow. In a study of about 85,000
consecutive adult patients admitted to the hospital with a heart attack between January 2019 and December 2020, those with a concomitant diagnosis of COVID-19 experienced a significantly higher mortality rate compared with patients who did not contract COVID-19.
Other data support the importance of inflammation triggered by a viral illness. For example, the incidence of cardiovascular events, including heart attacks and cardiovascular deaths, is higher among patients with influenza and influenza-like illnesses. Also, the likelihood of admission for acute heart attack during a seven-day risk interval after a diagnosis of influenza is increased six-fold. Influenza vaccination exerts a cardioprotective effect, especially in people aged 65 and over, and is associated with a reduction in adverse cardiovascular events.
The take home message is that viral illnesses like influenza and COVID-19 are likely to increase during the winter months and can exert a significant impact on morbidity and mortality, not just from the effects of the virus itself, but because of widespread inflammation that can damage the heart and blood vessels. Prevention of inflammation with appropriate vaccination can help avoid the resultant cardiovascular calamities, especially in individuals already at risk for heart attacks and strokes, and especially during the winter months.
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