Expert Blogs | Heart Health
Women: How COVID-19 Is a Threat to Your Heart
photo of doctor using stethoscope on patient

After more than two decades working in the hospital system, I went into private practice in Jan. 2020.

Now, like 5 million other women at that time, I was running my own business. 

Two months later my 5th Avenue office was forced to close for the pandemic. Two months later when I re-opened my doors (and struggled for more than a year to keep my practice afloat), 25 percent of my fellow women-business owners closed theirs for good. 

This was just the start of how the pandemic hit women especially hard. About 2.5 million women have lost their jobs or dropped out of the workforce since the pandemic, but that is just the start of the impact on women.

And if all that wasn’t enough, we’ve already started seeing the long-term impact of Covid-19 on women’s hearts. It is not a surprise, and yet it is. We knew that the impact of stress and lack of self-care that women have had to endure would heighten the risk of heart disease, which is already the number one killer of all women. What we didn’t expect, but is not proving true, is that Covid-19 was not just a disease of the lung, but it uniquely attacks the heart.

Covid-19 and Womens’ Hearts

A lot is still unknown about the COVID-19 or SARS-CoV-2 novel coronavirus that has upended the lives of people across the globe. After months of experience battling the pandemic, what we do know is that between 10 and 25 percent of patients hospitalized for COVID-19 have cardiac damage.

Research has shown that Covid-19 uniquely attacks the lining of our blood vessels, which in medical terms is called the endothelium. 

“Severe COVID-19 is a disease that affects endothelial cells, which form the lining of the blood vessels,” according to research by Johns Hopkins

The endothelium, which has been a significant part of my career as a preventative cardiologist, is the lining of the artery. It is the part of our arteries that protects against atherosclerosis and the buildup of plaque. It is the first thing that is affected when the arteries get stiff when high blood pressure, high cholesterol, elevated sugars and menopause happens. Microvascular disease, which is the smaller arteries that are often affected, are due to the damage to the endothelium. 

And, yes ladies, this too unfairly impacts women. Think of it like a lining of your pocketbook. You know, when the lining of the pocketbook gets torn, and everything in your pocketbook ends up between the lining and the outside. When that happens to the endothelium in the artery, cholesterol, inflammatory cells end up inside the lining, and that’s how plaque develops. 

Neither is it great for your arteries. The all-important blood is flowing through them and those little tears means there is a set up where disease potentially leaks in. No wonder a disease that attacks on our bodies vulnerabilities has had such an impact on our hearts. 

According to Dr. Leslie T. Cooper, chair, Enterprise Department of Cardiovascular Medicine for Mayo Clinic and the executive medical director and founder of the Myocarditis Foundation, the majority of patients hospitalized for COVID-19 with heart issues are those who are older and have a pre-existing heart condition.

Endothelial Disease for Women

Now here’s where it gets specific to women. The most common type of heart disease is atherosclerosis, which is coronary artery disease. It develops in your endothelium. But we’ve finally begun to understand that women’s arteries are different from men.

In men, the artery disease typically develops in a single, bad, and obvious spot. In women, artery disease is diffuse, with many of these little tears in many, many places which is anything but obvious. 

We don’t know exactly why this distinction exists, but we suspect it has to do with hormones and the protective effect of estrogen. Estrogen helps keep the arteries supple, elevates the HDL or the good cholesterol and helps protect the lining of the arteries. We also know that stress and depression, lack of sleep and the burden of all that women have had to deal with during the COVID-19 pandemic certainly has played a role in what we are going to see in the future when it comes to women’s hearts.

So Now What? 

The long-term impact of the pandemic’s attack on women will long be seen in women’s hearts. While we are well aware of the psychological and the economic toll of the pandemic on women, it is essential to understand the physical toll—no one has spoken of– what we are to expect regarding women and heart disease in the future.

Well, I am. 

As a cardiologist working in prevention for two decades, I am sadly confident that the statistics will soon show the impact that this pandemic has had on women and their hearts.

We are at a critical time in understanding the profound impact of these risks and are lagging behind in fully addressing them.

We can do better, across the board. We need to focus on the needs of women and the true issues at hand. We need to understand the psychosocial impact and the true devastation that COVID-19 has on our population of women, and most importantly, we need to anticipate and address the future.

We have had our wake-up call. We have seen the statistics. And here’s the good news: We know that 80 percent of heart disease is preventable, even the impacts of Covid-19. We can make larger investments in heart disease prevention instead of waiting for the disease to occur.

We can invest in modern technologies to make prevention more accessible, just as I have done with the launch of my med/tech company Heart-Tech Health. 

We can empower ourselves through healthy diet and exercise and early testing to ensure whatever impacts the physical and mental toll of the pandemic has exacted upon is mitigated through our lifestyle choices.

Ladies, we make 80 percent of the medical decisions for our family. Let’s make a great one for ourselves. Get a thorough check up. Learn about your heart and make necessary changes to ensure your best years remain ahead.



Photo Credit: FG Trade / E+ via Getty Images

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Suzanne Steinbaum, DO

Suzanne Steinbaum, DO

Board-certified cardiologist

Dr. Suzanne Steinbaum is a leader in preventive cardiology, now in private practice in New York. She launched heart prevention programs at Mt. Sinai Heart, Northwell Lenox Hill and Beth Israel. She is the CEO/Founder of Heart Tech Health, a technology-based prevention model. She published Dr. Suzanne Steinbaum’s Heart Book: Every Woman’s Guide to a Heart Healthy Life and has been an advocate for women's health for two decades appearing on The Doctors, Oz, The Today Show and Good Morning America. She now is an advisor and spokesperson for American Heart Association, Go Red For Women and Peloton.

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