How COVID-19 stress increases the risk of heart disease in women

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While the COVID-19 virus has killed more than 400,000 Americans and caused still unknown damage to millions more, the stress of enduring a global pandemic is also taking a toll, especially on women. 

According to the Centers for Disease Control and Prevention, two-thirds thirds of women play some sort of caregiver role, whether that’s to a spouse, children, parents, and/or neighbors –– and the need for such care has skyrocketed during the pandemic. 

“Most women are already doing unpaid caregiver work. Now they’re quarantining, they’re working at home, they’re helping their children with remote school,” said Sheralee D. Peterson, PA–C, a certified physician assistant at the Intermountain Healthcare Heart Institute. “At the same time, things that help relieve stress, such as direct access to strong social networks and physical activity, may be limited. It’s a disaster.”  

For National Heart Awareness Month in February, Intermountain Healthcare is raising awareness about the effects of COVID-19 pandemic stress on women’s heart health, and what can be done about it. 

Why is awareness vital? Cardiovascular disease remains the No. 1 killer of women – and too many women, particularly young women, remain unaware. Heart disease claims the lives of 1 in 3 women – that’s about one woman every 80 seconds.  

Stress Stresses the Heart 

Our bodies have natural ways to dealing with stress that’s often helpful. If you see a fire, the sympathetic nervous system springs into action, giving us what’s commonly known as a “fight or flight” response by flooding our body with epinephrine, also known as adrenaline, said Peterson.  

The hormone prompts us into action, thus possibly saving our lives and the lives of those around us. But with the COVID pandemic, it can feel as though the world is on fire for now almost a year – and that stress response never ebbs.  

That can – and does – take a toll on the human body and mind.  

“Our bodies are well equipped for minor, acute stressors, but they’re not really well-equipped for long-term, chronic stressors,” Peterson said.  

Too much epinephrine is associated with higher blood pressure, higher blood sugar and higher cholesterol, which in turn increases risk for heart disease. These effects are more pronounced in post-menopausal women, she added. 

A December study from the Journal of the American Heart Association found that women who felt more stressed at their jobs, in their roles as caregivers, mothers, and spouses,had greater chances of developing high blood pressure, gaining weight, and eating a less healthy diet, all factors that contribute to poorer heart health. 

Also last year, researchers found a four-fold increase in incidences of stress cardiomyopathy, more commonly known as broken heart syndrome, between March 1 and April 30 of 2020, compared to the same time period in 2019.  

Stress cardiomyopathy typically occurs in women, often after divorce or death of a loved one, and mimics a heart attack. While most patients usually make a full recovery, it’s still a signal of hearts gone haywire as a result of acute stress.  

The Logistics of Pandemic Stress Relief 

While COVID-19 stress affects both genders, women, particularly caregivers, have been less likely to engage in activities proven to alleviate the stress itself. Many have been caught in a pandemic stress cycle that’s now entering its second year.  

“Most of us know what to do about stress: we should exercise, reach out to friends, and stick to a healthy diet,” said Peterson. “We’ve read it a zillion times before, but we don’t often address the ‘how’ in making sure women can carve out time to follow that advice. It feels disingenuous if we don’t talk about what steps we all must take to make this happen.” 

Doing so requires a paradigm shift.  

This starts with women giving themselves permission and “honor the fact that taking time for themselves makes us better mothers, partners, sisters, neighbors, co-workers, whatever we need to be, especially since a lot of women defer self-care as they continue to try and be all things to all people,” she said.  

Recognizing that women need this time may involve difficult conversations with those in their care, but it’s crucial for women who want to continue to keep showing up at their fullest capacity. 

Then, Peterson said, women can start making small changes with a focus on their overall health that will protect their hearts.  

“These don’t need to be major changes all at once either. Starting a completely new yoga routine, for example, may seem daunting, but focusing instead on deep breathing and slow movement, which is a lot of what yoga does, and reduces cortisol can help,” she said.  

Mindfulness practices can reduce stress, but so can the simple act of keeping a gratitude journal and listing a few things to be grateful for each day. 

Peterson said that rebuilding social networks is also crucial, especially if they’ve been stunted by not being able to see non-household members in person.  

While virtual calls may not bring the same kind of connection as in-person activities will, having a “resiliency buddy,” who you can talk to without feeling like being judged, can help relief tension and stress.  

“These small changes can lead to bigger ones, as stress levels lower and make doing things like sleeping, having time and energy to exercise, and making better food easier to do, which in turn starts a different kind of cycle: creating a healthier body and therefore better heart health,” Peterson noted.  

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