Millions of medical appointments and screenings have been cancelled or postponed during the pandemic because facilities closed or patients were too nervous to go to the doctor’s office. As women start to return to the doctor, we asked several Northside experts their advice for women on where they should start. What screenings should they get first? And is it safe to even go to the doctor?
What trends have you seen over the past year in your own practice?
Like all providers, early 2020 clinic visits dropped to minimal numbers. However, I have seen a significant increase in outpatient clinic visits in the last six months.
I have also seen an increase in stress/anxiety in many patients as well. My observation is the various pressures of the last 18 months have led to increased depression, anxiety and weight gain for many patients. I have also seen stress/anxiety lead to increase complaints of chest pain, fatigue, exhaustion and “not feeling well.”
Why are regular check-ups important?
An estimated 80% of heart disease is preventable. Regular check-ups evaluate and manage cardiovascular risk factors that prevent cardiovascular events such as heart attack, stroke, atrial fibrillation and congestive heart failure.
As women start to go back to the doctor, what advice do you have about where they should start? What should they do first?
I recommend a routine checkup with a primary care physician. Everyone should have routine labs including cholesterol and blood sugar (glucose) check. I also recommend everyone have a blood pressure check. If a woman has a family history of hypertension or an elevated blood pressure reading in the office, it is important to monitor home blood pressure. Also, during the COVID19 pandemic many women did not have routine cancer screening. If age appropriate, it is important to get routine mammograms, colonoscopies and gynecologic exams.
Why do women experience high rates of heart disease?
Heart disease is the leading cause of death among women. About 1 in every 5 female deaths is related to heart disease. Some of this is due to aging population and women having greater life expectancy. However, there is a concerning trend of increasing heart disease in women under the age of 55.
Traditional cardiovascular risk factors like weight, diet, physical activity, diabetes, blood pressure and cholesterol account for a majority of this increase in heart disease among women. The prevalence of obesity and physical inactivity is higher among women compared with men. The rate of type 2 diabetes among women is increasing, and diabetes is known to confer greater risk for heart disease death in women compared with men.
Women do have some nontraditional risk factors that contribute to cardiovascular risk: preterm delivery, hypertensive disorders during pregnancy, gestational diabetes, autoimmune diseases such as lupus and rheumatoid arthritis, radiation and chemotherapy for breast cancer and peripartum cardiomyopathy are a few.
How does stress impact a woman’s heart health?
One study showed that people with chronic stress related to marital or other home concerns or financial stress were twice as likely to have a heart attack as those without chronic stressors. However, it is important to remember that stress is difficult to measure.
Is it safe to go to the doctor? What advice do you have for patients who are still too nervous? It is safe to go to the doctor.
I strongly recommend everyone eligible for the COVID-19 vaccine receive the vaccine. This will give patients protection from severe COVID-19 during doctor visits, work, school and various daily activities. Doctor office visits are requiring patients and providers to wear a mask. I encourage everyone to make appropriate health care appointments and bring a mask to those appointments.
Anything else you’d like to add?
If you have any clinical concerns about the COVID19 vaccine, I encourage all patients to discuss those clinical concerns with their health care provider.
Dr. Kimberly Champney is a board-certified cardiologist, with special interests that include women’s cardiovascular care and cardio oncology. She sees patients at Northside Hospital Cardiovascular Care, a Northside network provider, in Atlanta, Ga.
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