Amongst many things, the COVID-19 pandemic questioned our traditional, separated work-home lifestyle divide ingrained over generations. The paradigm shift, to working from home (WFH) promised individuals the return of and flexibility with time – no more commutes, distractions, nor concrete set hours. Initially, this “gift” from COVID provided nuclear families and co-habitants with more time together, gave flexibility and some freedoms back to the individual, and overall was beneficial to many. However, underneath the rose petals of WFH, the thorns of raised risks of cardiovascular diseases (CVDs) present a menacing and longer-term health threat.

CVDs are characterised as a group of diseases (not exhaustive) including myocardial infarction, congestive heart failure, and myocardial ischemia, which affect the heart and blood vessels¹. Currently, CVDs are the leading cause of death globally². Though pharmaceutical intervention has helped reduce CVD prevalence and mitigate the risk of mortality over the years, its pathogenesis from multifactorial causes emphasises the importance of managing behavioural risk factors². More specifically, tabacco use, alcohol, physical inactivity, hypertension, obesity, and inadequate dietary intakes are proportional to CVD risk².

The impact of predisposing CVDs on COVID infection risks and outcomes has been extensively researched. However, the relationship of COVID infection and changed behaviours on the emergence of CVDs remains a novel topic. When SARS-Cov-2 spread and lockdowns commenced, communities and people were forced to stay in their homes, the subsequent lifestyle changes posed a physiological threat. As established, physical activity has a prophylactic effect on CVD². The decrease in activity to just basal metabolic rate from removing daily activities such as commuting to work, and the consequence of increased sedentary time due to longer work hours, increases the risk of cardiovascular disease by promoting weight gain³.

Weight gain leads to increased obesity rates. Studies have suggested that 1/3 Australians gained weight during the pandemic, as well as 42% of Americans stating weight gain, with more than 16 United States of America states now having obesity rates of 35% or higher⁷. The accepted hypothesis linking obesity to CVD is centred on the ability of adipose tissue to produce pro-inflammatory cytokines, which directly impair myocardial function and contribute to the formation of atherosclerotic plaques⁸. This weight gain and consequential increased CVD risk is compounded further by irregular eating behaviours such as snacking and increased consumption of highly processed foods, which also promote atherosclerosis of blood vessels and hypertensive characteristics¹.

The complex impacts of WFH also exacerbate other pre-disposing CVD risk factors through behavioural changes¹. During lockdown, alcohol sales increased by 29% with tobacco expenditure increasing by 13%^4,5, being used by some to mitigate the psychosocial pressure of lockdown. Increased tobacco and alcohol intakes indirectly increase CVD risk through blood pressure elevation, increases in cholesterol, and increases in triglyceride levels⁶.

COVID-19 presented WFH as a lifestyle delicacy on a silver platter. However, masked by the initial charade of increased work flexibility and freedom, the menacing wave of CVD health risks threatens the community in the longer term. CVD risks are multifactorial, whereby control of the modifiable risk factors can help mitigate the risk and severity. With WFH becoming the normalised practice, community programs should be initiated to emphasise the importance of staying active, eating healthy, and reducing alcohol and tobacco intake. As a community, we were able to slow but not stop COVID-19 from taking our breath away, but individually we can stop behavioural and lifestyle changes from contributing to our community’s longer-term CVD and mortality. 

References

1. Ruan Y., et al., Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. Biomed Central, 2018, 18(1): p. 778
2. Muhammad D.G. et al, COVID-19 lockdown may increase cardiovascular disease risk factors. The Egyptian Heart Journal, 2021, 73(1): p. 2
3. Powell-Wiley T.M., et al, Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation, 2021, 143(21): e984–e1010
4. Huge increase in Australian alcohol sales during the COVID-19 pandemic, Meacham S., 9NEWS, 2022, Accessed 14JUL2022, Available at https://www.9news.com.au/national/covid19-pandemic-blamed-for-huge-increase-in-alcohol-sales-across-australia/b8da58fa-b7b8-4d81-87ef-2baee80148ca
5. Lee B.P., et al., Retail Alcohol and Tobacco Sales During COVID-19. Annals of Internal Medicine, 2021
6. Larsson S.C., et al., Alcohol Consumption and Cardiovascular Disease. Circulation, 2020, 13(3): e002814
7. Has the Pandemic Affected Obesity Rates?, Beaumont, [Unknown Author], 2022, Accessed 14JUL2022, Available at https://www.beaumont.org/health-wellness/blogs/has-the-pandemic-affected-obesity-rates
8. Carbone S., et al., Obesity paradox in cardiovascular disease: where do we stand?. Vascular Health and Management Risk, 2019, 15(1): p. 89-100