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Preventive Cardiology Clinic

COVID-19: Why Protecting Your Heart Matters

A growing number of strange symptoms are being linked to COVID-19. From strokes to blood clots, research reveals the virus may damage the endothelium.

What’s that?

The endothelium (en-dough-THEEL-yum) is a very thin, delicate layer of cells which covers up the tissues which make up a blood vessel’s wall. The endothelium is an essential barrier — and keeping it healthy is vital in keeping blood flowing smoothly throughout our body.

An unhealthy endothelium is at higher risk of breaking down or sloughing. Those with cardiovascular risk factors like high cholesterol, high blood pressure, diabetes, smoking, obesity, lack of physical activity — and poor eating habits — are more likely to have an unhealthy endothelium.

If the endothelium breaks down or sloughs, the raw tissue underneath is exposed to the blood flowing past it – much like if you sloughed off a bunch of skin off your hand and that underling raw tissue was exposed to the air. The body’s automatic reaction is to try to heal the injury. On your hand, you would form a scab. On the inside of a blood vessel, you would form a clot. That blood clot inside a blood vessel is the body’s equivalent of the scab on your hand. That blood clot is also what can cause a heart attack or stroke.

More on COVID-19…

When the pandemic first hit, doctors were surprised that a virus that seemed to zero in on the lungs, was greatly affecting people with pre-existing conditions like high blood pressure, high cholesterol, diabetes, and heart disease.

However, a report published in the New England Journal of Medicine has shined light on the reason. Autopsy evaluations of lungs from patients who succumbed to COVID-19 displayed signs of severe endothelial injury in lung blood vessels, with the virus actually present within the endothelial cells themselves. Not surprisingly little blood clots were found throughout those blood vessels – something that is not really seen in cases of other viral infections (like influenza).

And here's the big “aha” moment: If this virus works by causing endothelial damage, those of us with an already weakened endothelium (based on high cholesterol, high blood pressure, diabetes, obesity, smoking, inactivity or poor diet) could be much more susceptible to some of the more serious consequences of a COVID-19 infection.

Once you start to look at COVID-19 as a virus that attacks the endothelium, all of the seemingly disconnected symptoms we’ve been seeing – from lung problems to strokes — start to make total sense. The endothelium lines EVERY blood vessel in our body. So, EVERY blood vessel is at risk – especially in those individuals who have pre-existing conditions that contribute to endothelial cell dysfunction.

The solution…

We know how to fix a weakened endothelium! Pharmaceuticals like statins and certain common blood pressure lowering medications are known to possess endothelium-stabilizing properties. And research is showing promise that these drugs can help improve survival in people sickened by the virus. And that those with controlled risk factors fare better when infected.

But as a preventive cardiologist, my advice is not to wait until you have COVID-19 to start worrying about your endothelium! Act NOW to make your endothelium as strong as possible so you’re better able to withstand an infection. That means attending to your cholesterol, your blood pressure, your blood sugar, your weight, your diet, your activity levels and your tobacco use. In other words, now is the time to kick your heart disease prevention efforts into their highest gear!

How we can help

At Preventive Cardiology Clinic, care begins with a conversation. We spend time with you to really learn about what symptoms you are experiencing, what your risk factors are, and what you hope to achieve in terms of your health. A typical first consultation with Dr. Klodas takes approximately one hour. During that time, we will go over your general health history, your heart history, your cardiac risk factors and your diet. Please call 952-929-5600 to schedule your consultation today. Learn more.

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