Early in the course of the pandemic it was recognised that people with existing health problems, including heart or other vascular diseases, may be at higher risk of complications from COVID-19. Separately, it began to emerge that COVID-19 may itself cause blood clotting disorders, including heart attacks and strokes.

The British Heart Foundation (BHF) has issued guidance on COVID-19 and what it means for people with existing heart disease. It provides information for people by specific diagnosis, such as angina, high blood pressure or heart rhythm problems. The over-arching message is that “anyone with a heart condition is considered at increased risk of more severe complications of Covid-19. If you’re also over 70, you’re at particularly high risk.”

BHF advise that no one in the UK needs to shield anymore (excluding localised lockdown areas) unless they are in the highest risk groups which include anyone who’s had a heart transplant, anyone who is pregnant and has heart disease, or if advised to shield by a doctor.

Where did the story come from?

Advice on COVID for people with cardiovascular disease was published by the British Heart Foundation in their magazine Heart Matters. The information was last updated on 3 August 2020.

What advice does the British Heart Foundation give?

The British Heart Foundation gives advice from their medical experts according to a specific cardiovascular condition. This is given in a question and answer format by condition.

In general, the BHF emphasise that having a cardiovascular condition doesn’t make you more likely to catch COVID-19, but that if you get the virus you are at a higher risk of complications. They describe three levels of risk as:

  • high risk
  • particularly high risk
  • at most risk (extremely vulnerable)

For example, having cardiovascular disease and being over 70 years of age or having co-existing kidney or lung disease automatically places someone in the ‘particularly high risk’ category. Anyone who’s had a heart transplant is considered to be ‘at most risk’.

For common conditions such as diabetes, high blood pressure, angina, past heart attacks or heart failure, the advice generally covers:

  • that the condition is recognised to be high risk – or particularly high risk in specified cases
  • the importance of continuing to take any prescribed medications to keep the condition well-controlled which may reduce risk
  • carefully following advice on social distancing and handwashing and limiting the number of close interactions with different people
  • advice for specific scenarios, such as staying safe as lockdown eases and returning to workplaces
  • being aware of other lifestyle factors that may further increase risk, such as avoiding smoking, excess alcohol, staying physically active, eating a balanced diet and losing weight if necessary

For other specific conditions, such as heart valve or rhythm problems or congenital heart conditions, the advice is more variable and specific. For example, BHF notes that there is no evidence that COVID-19 affects the function of pacemakers or implanted devices, but a person’s risk will depend on the specific reason this was inserted. They also note the lack of evidence on whether or not the common heart rhythm problem of atrial fibrillation is associated with increased risk.

What do trusted sources say?

The European Cardiology Society has guidance on the diagnosis and management of cardiovascular disease during the COVID-19 pandemic. This explains the effects that the SARS-CoV-2 virus may have upon the cardiovascular system and the fact that blood clots, heart muscle damage and heart rhythm problems are recognised complications of severe infection. It also highlights that existing cardiovascular disease, particularly in a person of increased age, is associated with increased risk of complications and mortality in COVID-19 infection.

The guidance gives recommendations for health professionals, including triage systems to prioritise care, protective measures for cardiology patients, and management of specific conditions.

Analysis by EIU Healthcare, supported by Reckitt Benckiser

 

Citation

  1. British Heart Foundation. Coronavirus: what it means for you if you have heart or circulatory disease. Heart Matters Magazine. Published 03 August 2020.

 

Reading list

  1. European Society of Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. Last update 10 June 2020.