IMPLICATIONS OF THE COVID-19 PANDEMIC FOR CARDIOVASCULAR DISEASE AND RISK FACTOR MANAGEMENT.

COVID-19 and our public health responses to the pandemic may have far-reaching implications for cardiovascular risk affecting the general population and not just survivors of COVID-19. In this narrative review, we discuss how the pandemic may impact general cardiovascular risk for years to come, and explore the mitigating potential of telehealth interventions. From a health care perspective, the shift away from in-person office visits may have led many to defer routine risk factor management and may have had unforeseen effects on continuity of care and adherence. Fear of COVID-19 has led some patients to forego care for acute cardiovascular events. Curtailment of routine outpatient laboratory testing has likely delayed intensification of risk-factor modifying medical therapy, and drug shortages and mis-information may have negatively impacted adherence to antihypertensive, glucose-lowering, and lipid-lowering agents. From a societal perspective, the unprecedented curtailment of social and economic activities has led to income loss, unemployment, social isolation, decreased physical activity, and increased frequency of depression and anxiety, all of which are known to be associated with worse cardiovascular risk-factor control and outcomes. We must embrace and evaluate measures to mitigate these potential harms to avoid an epidemic of cardiovascular morbidity and mortality in the coming years that could dwarf the initial health impacts of COVID-19.