Dr Mariana Garcia: We Cannot Overlook the Influence of Psychological Distress on Our Patients

Not only has the pandemic exacerbated cardiovascular care, but it has had devastating effects on patients' mental health, noted Mariana Garcia, MD, cardiology fellow in the Academic Clinical Investigator Pathway at Emory University and member of T32, Multidisciplinary Research Training to Reduce Inequalities in Cardiovascular Health (METRIC).

Transcript

Will cardiovascular outcomes be exacerbated by the pandemic?

So, with the pandemic, it's been kind of both ways. On one way, we know that cardiovascular care has been affected by the pandemic, because data have shown that there's been delay in seeking care and receiving timely treatment. But on the other end, we're also seeing the implications of COVID-19 for mental health, which have been devastating. So I think, with these 2 pathways underway during the pandemic—it wasn't part of our study or what were what we were looking into—I think we have to be ready for what cardiovascular outcomes will be from this.

Is there a need for additional preventive measures to avoid adverse outcomes in patients with no comorbidities?

One treatment pathway could definitely be whether medications such as antidepressants or other psychotropic medications could be helpful to even lower cardiovascular outcomes, right? Data [have] been mixed, with no strong conclusion that we can make, but because it hasn't necessarily translated to decreased event rates, it's definitely one pathway to explore for future research.

Another possibility is treating the inflammation. There's a huge number of researchers out there looking into that. However, the one thing that we do want to emphasize is that making sure that patients are on the appropriate guideline-directed secondary preventative medications is extremely important. Because it is possible that these medications, such as statin and aspirin, may be protective for these effects of stress in everyday life. So those are 2 pathways.

And I think just overall, equally important is that our findings suggest that as cardiologists, we should really be cognizant of considering regular psychological assessments, which we might necessarily do in our everyday practice, and equally important [is to] explore treatment modalities. In addition to traditional medical therapy and cardiac rehab, maybe consider meditation and relaxation techniques or any other holistic approach. So those are the avenues we can think of.