Optimising Secondary Prevention and Cardiac Rehabilitation for Atherosclerotic Cardiovascular Disease During the COVID-19 Pandemic: A Position Statement From the Cardiac Society of Australia and New Zealand (CSANZ)

Abstract

Recommendations Every effort should be made to deliver safe, ongoing access to health care professionals and the use of evidenced based therapies in individuals with CVD. An increase in use of a range of electronic health platforms has the potential to transform secondary prevention. Integrating research programs that evaluate the utility of these approaches may provide important insights into how to develop more optimal approaches to secondary prevention beyond the pandemic.

Recommendations for Cardiovascular Prevention During the Sars-Cov-2 Pandemic: An Executive Document by the Board of the Italian Society of Cardiovascular Prevention

“…One indirect consequence of the continuing diversion of clinical resources required by the acute management of Covid-19, as mentioned above, is represented by a considerable reduction of routine CVD risk screening and delays in follow-up appointments [14]. On the one hand, the loss of free access to doctors is worrying, but on the other the current technological evolution allows us to be able to integrate clinical practice with telemedicine and with home control of risk factors [10]. Through the implementation of these two approaches, in fact, a constant medical relationship with patients can and should be preserved, in order to detect CV risk factors early, manage them carefully, avoiding medical inertia by doctor as well as poor adherence by patients [15,16].…”

“…Patients should also be instructed how to maintain adequate supplies of their chronic medication during this pandemic i.e. through email or home-delivery [19,20] At this time, telehealth can be particularly useful in CV medicine which heavily relies on clinical history and can make care more accessible and affordable potentially reducing disparities in access to care for rural, regional and remote areas [10], and for vulnerable populations (people with disabilities).…”

“…Smoking presents a significant risk for patient during the Covid-19 pandemic. Indeed, smoking not only promotes a greater risk of future CV events, but also increases the risk of infection via hand-to-mouth contact, provides a potential adhesion site for the Sars-Cov-2 virus through upregulation of angiotensin-converting enzyme-2 receptors and associates with more severe pulmonary complications [10].…”

“…Therefore, primary and secondary CV prevention efforts should not be forgotten at this time, since having direct implications for reducing the burden of current and eventual future viral outbreaks and not only to improve CV health [ 8 – 10 ]. For patients with established atherosclerotic CV disease (CVD), limitations in the access to the healthcare system resources has potential implications to receive secondary prevention strategies.…”

“…At this time, telehealth can be particularly useful in CV medicine which heavily relies on clinical history and can make care more accessible and affordable potentially reducing disparities in access to care for rural, regional and remote areas [ 10 ], and for vulnerable populations (people with disabilities). Recommendation 8 Refer to reliable scientific sources to evaluate the impact of chronic therapies during the pandemic.…”