key: cord-0729995-fksfz90o
authors: Khera, Amit
title: ASPC President’s message: The work must go on
date: 2020-07-24
journal: Am J Prev Cardiol
DOI: 10.1016/j.ajpc.2020.100039
sha: 841472e8355a01c477d9b5bee3a7eda977835765
doc_id: 729995
cord_uid: fksfz90o

nan

ASPC President's message: The work must go on

The coronavirus disease 2019 (COVID-19) pandemic has impacted every facet of our lives, disrupting our health care system, stripping our vocational activities, and blocking our social connections. The toll on human life has been profound and from the early shock of its rapid ascent, there is now growing realization that virus will cohabitate with us for some time to come. In this new normal, several applications of preventive cardiology are coming into sharper view.

There is now quite convincing evidence that those with and at risk for cardiovascular disease (CVD) are not only at increased risk of acquiring COVID-19 infection, but also succumbing from the disease [1] . The early focus on managing the acute and severe manifestations of the infection has expanded to appreciate the secondary and tertiary health impacts of the disease [2] . Consistent reports across the globe have confirmed that patients are avoiding treatment for acute cardiovascular conditions such as myocardial infarction and stroke, with a 23% and 20% reduction in emergency department visits for each respectively [3] , and with a concomitant increase of more severe presentations and out of hospital cardiac arrest from these delays. Further, disruption in the continuity of clinical visits, worsening lifestyle habits with social distancing, and increased stress and anxiety all will likely contribute to a dreaded third wave of illness from interrupted preventive care. Indeed, more than 72 million ambulatory visits for CVD occur annually in the U.S. and all outpatient visits have declined by a staggering 60% in the initial weeks of the COVID-19 pandemic [4, 5] . Importantly, given that over 18 million individuals die of CVD worldwide annually, even a small proportional increase in this number due to COVID-19 disruptions in preventive care will result in a large number of increased deaths.

Unfortunately, we are also witnessing the disproportionate effect of the COVID-19 pandemic on the African American community and other communities of color. COVID-19 infection rates are significantly higher in African Americans relative to their proportion of the population and COVID-19 death rates appear to be two times higher among African Americans relative to other groups [6] . Similarly, hospitalization rates among American Indian and Hispanic populations are several fold higher than in white populations [7] . Further, ongoing episodes of racism and violence affecting the African American community continue to inflict a toll on cardiovascular health, and exacerbate the disparities in CVD outcomes for this group. In this environment, we must redouble our commitment to address the social determinants of health and to be a strong advocate for the health of all communities.

During these challenging times, the important work of preventive cardiology cannot take a respite and in fact, the need for preventive cardiology practice is even more imperative. Combating the coming waves of preventable COVID-19 related CVD will require a proactive stance with implementation of several strategies including broader application of telehealth, addressing barriers to medication access, providing creative approaches to preserving physical activity and healthy nutrition, and leveraging the broader preventive care team [2] . Similarly, the dissemination of new knowledge and best practices through scientific journals such as the American Journal of Preventive Cardiology must continue.

In this vein, the American Society for Preventive Cardiology (ASPC) will soon host our 2020 Virtual Summit on CVD Prevention. From the disappointment of not being able to meet face to face with our members and colleagues came the realization that the conference topics had immediate relevance and should not be deferred. We will hear from experts on prevention issues for CVD in African Americans as well as Hispanics. Former ASPC President and Executive Director of Million Hearts, Laurence Sperling, MD, will describe population approaches to CVD prevention. There will be a series of presentations on aspects of CVD in women, as well discussions on lessons learned from the recent ISCHEMIA and polypill trials. The pivot to a virtual platform, while borne out of necessity, will offer several innovative opportunities for engagement. Importantly, it will afford the ability to reach a much broader audience including a sizeable contingent of international participants.

While some may view preventive cardiology as sidelined during the momentous struggle against acute COVID-19 related illness, I actually feel the opposite. This is the time for preventive cardiologists to step in, step up, and engage in the fight to keep our population healthy during these challenging times. The work must go on.

Clinical characteristics of coronavirus disease 2019 in China

Continuity of care and outpatient management for patients with and at high risk for cardiovascular disease during the COVID-19 pandemic: a scientific statement from the American Society for Preventive Cardiology

Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions -United States

The Impact of the COVID-19 Pandemic on Outpatient Visits: Practices Are Adapting to the New Normal

National Ambulatory Medical Care Survey: 2016 National Summary Tables

What do coronavirus racial disparities look like state by state?. Accessed, htt ps://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-corona virus-racial-disparities-look-like-state-by-state

COVID-19 in racial and ethnic minority groups. accessed