Cardiovascular Disease Prevention and Implications of Coronavirus Disease 2019: An Evolving Case Study in the Crescent City.
Cardiovascular Disease Prevention and Implications of Coronavirus Disease 2019: An Evolving Case Study in the Crescent City.
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DOI：
10.1161/jaha.120.016997
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发表时间：
2020-07-07
影响因子：
5.4
通讯作者：
Bazzano LA
中科院分区：
文献类型：
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作者：
Razavi AC;Kelly TN;He J;Fernandez C;Whelton PK;Krousel-Wood M;Bazzano LA
传统上，医学和公共卫生将传染性疾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，特别是在心血管疾病（CVD）的背景下。总体而言，与普通人群相比，患有严重急性呼吸综合征冠状病毒2的基础CVD的个体的病死率高出10倍。尽管大流行对心血管健康的影响仍在不断演变，但很少有人从一线公共卫生的角度对心血管疾病和COVID-19影响不成比例的人群定义这种关联。路易斯安那州在心血管健康方面排在最后5位，并且它是全国COVID-19病死率最高的几个教区的所在地。在此，我们回顾了洛杉矶新奥尔良的心血管疾病预防和COVID-19的影响，新奥尔良是一个拥有清醒但有弹性的历史的城市，以前的公共卫生灾难。特别是，我们讨论了在获得医疗保健，预防性药物治疗和生活方式行为方面的潜在大流行驱动的变化，所有这些都可能对CVD预防和管理产生不利影响，同时扩大种族差异。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中如何改善CVD预防工作的建议。
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.