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While the COVID-19 virus has killed more than 400,000 Americans and caused still unknown damage to millions more, the stress of enduring a global pandemic is also taking a toll—especially on women.
Two-thirds of women play some sort of caregiver role, whether that's to a spouse, children, parents, and/or neighbors—and the need for such care has skyrocketed during the pandemic, according to the Centers for Disease Control and Prevention.
"Most women are already doing unpaid caregiver work. Now they're staying at home, many are working at home, while others are essential workers who're helping children with remote school," said Sheralee D. Petersen, PA–C, a certified physician assistant at the Intermountain Healthcare Heart Institute. "At the same time, things that help relieve stress, such as direct access to strong social networks and physical activity, may be limited. These factors compounded by all the uncertainties surrounding the pandemic have led to increased stress and burnout."
For National Heart Awareness Month in February, Intermountain Healthcare is raising awareness about the effects of COVID-19 pandemic stress on women's heart health, and what can be done about it.
Why is awareness vital? Cardiovascular disease remains the no. 1 killer of women—and too many women, particularly young women, remain unaware of their risk. Heart disease claims the lives of 1 in 3 women—that's about one woman every 80 seconds.
Stress stresses the heart
Our bodies have natural ways to deal with stress that's often helpful. If you see a fire, the sympathetic nervous system springs into action, giving us what's commonly known as a "fight or flight" response by flooding our body with stress hormones, said Petersen.
Stress hormones prompt us into action, thus possibly saving our lives and the lives of those around us. But with the COVID pandemic, it can feel as though the world is on fire for now almost a year—and that stress response never ebbs.
That can—and does—take a toll on the human body and mind.
"Our bodies are well equipped for minor, acute stressors, but they're not as well-equipped for long-term, chronic stressors," Petersen said.
High levels of stress hormones are associated with higher blood pressure, higher blood sugar, higher cholesterol, and increased inflammation which in turn increases risk for heart disease. These effects are more pronounced in post-menopausal women, she added.
A December study from the Journal of the American Heart Association found that women who felt more stressed at their jobs, in their roles as caregivers, mothers, and spouses, had greater chances of developing high blood pressure, gaining weight, and eating a less healthy diet, all factors that contribute to poorer heart health.
Also last year, researchers found a four-fold increase in incidences of stress cardiomyopathy, more commonly known as broken heart syndrome, between March 1 and April 30 of 2020, compared to the same time period in 2019.
Stress cardiomyopathy typically occurs in women, often after divorce or death of a loved one, and mimics a heart attack. While most patients usually make a full recovery, it's still a signal of hearts gone haywire as a result of acute stress.
The logistics of pandemic stress relief
While COVID-19 stress affects both genders, women, particularly caregivers, have been less likely to engage in activities proven to alleviate the stress itself. Many have been caught in a pandemic stress cycle that's now entering its second year.
"Most of us are familiar with the common recommendations for reducing stress: we should exercise, sleep well, reach out to friends, and stick to a healthy diet," said Petersen. "We've heard it many times before, but we don't often address the 'how' in making sure we carve out time to follow that advice. It feels disingenuous if we don't talk about what steps we all must take to make this happen."
Doing so requires a paradigm shift.
Petersen said this starts with women giving themselves permission and "honoring the fact that taking time for themselves makes us better mothers, partners, sisters, neighbors, co-workers, whatever we need to be, especially since a lot of women defer self-care as they continue to try and be all things to all people."
It is hard to change this habit of deferring self-care, but it's crucial for women who want to continue to keep showing up at their fullest capacity. There is value in taking time to evaluate your stress mindset first. A growth mindset will improve any women's experience in reducing their stress.
Then, Petersen said, women can start making small changes with a focus on their overall health that will protect their hearts.
"These don't need to be major changes all at once either. Starting a completely new yoga routine, for example, may seem daunting, but focusing first on a deep breathing practice a few times a day can have significant benefit," she said.
Mindfulness practices can reduce stress, but so can the simple act of keeping a gratitude journal and listing a few things to be grateful for each day.
Petersen said that rebuilding social networks is also crucial, especially if they've been stunted by not being able to see non-household members in person.
While virtual calls may not bring the same kind of connection as in-person activities will, having a "resiliency buddy," who you can talk to without fear of being judged, can help relieve tension and stress.
"These small changes can lead to bigger ones, as stress levels lower and make doing things like sleeping, having time and energy to exercise, and eating nutrient-dense foods easier to do, which in turn starts a different kind of cycle: creating a healthier body and therefore better heart health," Petersen noted.
For more information on heart health, go to https://intermountainhealthcare.org/services/heart-care/