Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA.
Department of Medicine Tulane University School of Medicine New Orleans LA.
J Am Heart Assoc. 2020 Jul 7;9(13):e016997. doi: 10.1161/JAHA.120.016997. Epub 2020 May 16.
Medicine and public health have traditionally separated the prevention and treatment of communicable and noncommunicable diseases. The coronavirus disease 2019 (COVID-19) pandemic has challenged this paradigm, particularly in the setting of cardiovascular disease (CVD). Overall, individuals with underlying CVD who acquire severe acute respiratory syndrome coronavirus 2 experience up to a 10-fold higher case-fatality rate compared with the general population. Although the impact of the pandemic on cardiovascular health continues to evolve, few have defined this association from a frontline, public health perspective of populations disproportionately affected by CVD and COVID-19. Louisiana is ranked within the bottom 5 states for cardiovascular health, and it is home to several parishes that have experienced among the highest COVID-19 case-fatality rates nationally. Herein, we review CVD prevention and implications of COVID-19 in New Orleans, LA, a city holding a sobering yet resilient history with previous public health disasters. In particular, we discuss potential pandemic-driven changes in access to health care, preventive pharmacotherapy, and lifestyle behaviors, all of which may adversely affect CVD prevention and management, while amplifying racial disparities. Through this process, we highlight proposed recommendations for how CVD prevention efforts can be improved in the midst of the current COVID-19 pandemic and future public health crises.
医学和公共卫生传统上将传染病和非传染性疾病的预防和治疗分开。2019 年冠状病毒病(COVID-19)大流行对这一模式提出了挑战,尤其是在心血管疾病(CVD)方面。总的来说,患有潜在心血管疾病并感染严重急性呼吸综合征冠状病毒 2 的个体的病死率比一般人群高 10 倍。尽管大流行对心血管健康的影响仍在不断演变,但很少有人从受 CVD 和 COVID-19 影响不成比例的人群的一线公共卫生角度来定义这种关联。路易斯安那州的心血管健康状况在全美排名倒数第五,该州有几个教区的 COVID-19 病死率在全国名列前茅。在此,我们回顾了新奥尔良,路易斯安那州的 CVD 预防和 COVID-19 的影响,该市拥有一段令人警醒但又充满韧性的历史,曾经历过以前的公共卫生灾难。特别是,我们讨论了大流行可能导致的医疗保健、预防药物治疗和生活方式行为方面的变化,这些变化都可能对 CVD 的预防和管理产生不利影响,同时放大种族差异。通过这一过程,我们强调了在当前 COVID-19 大流行和未来公共卫生危机期间,如何改进 CVD 预防工作的建议。