AUSTIN, Texas >> Dr. Stanley Wang, a cardiologist at Austin Heart Central at the Heart Hospital of Austin, has been sending his patients the same message for months: If they get COVID- 19, they are among the highest-risk patients for severe disease and hospitalization.

Most are listening and have been vaccinated, and he’s continuing to have the conversation about what they can do to lessen their risks:

Get vaccinated

Wang says he has frank conversations using statistics, such as that being unvaccinated makes you eight times as likely to get the delta variant of COVID-19 and 25 times more likely to be hospitalized or die.

Some patients worry about the small percentage of people who have had heart inflammation after a vaccine (mostly younger men). Wang reminds them that a COVID- 19 vaccination has a tiny risk of complications, but people with preexisting heart conditions are two to three times as likely to have complications from COVID-19, and those complications could continue for years.

He’s also talking to vaccinated patients about getting a third shot.

Don’t skip your regular medication

There is a correlation with COVID-19 causing elevated blood pressure as well as blood pressure that is difficult to control, Wang said.

“COVID is a disease of inflammation, and that can overlap with high blood pressure, causing the body to go into overdrive and bad things to happen,” he said.

People who already have high blood pressure need to have it well controlled with medication to put themselves in the best position to fight COVID-19 or any other infection.

Stay out of the hospital

The delta variant is still straining some hospital systems, and while hospitals are still able to handle heart attacks or strokes, the COVID-19 surge has meant that some patients who need routine cardiac surgeries or other procedures might still have to wait.

Be heart-healthy

Wang and other cardiologists have noticed the long-term effects the pandemic is having on their patients. It’s not uncommon for patients to come in weighing 15 to 20 pounds more than a year ago, he said.

“The weight is still going to be a problem down the road,” he said.

Many are not exercising as much and have become socially isolated, which is affecting mental health.

This pandemic also might increase the need for previously healthy people to see a cardiac specialist.

“We worry about long-term consequences — diabetes, heart attacks, strokes — all things expected from unhealthy behaviors,” Wang said.

A new group of patients

Wang and his colleagues now are seeing people recovering from COVID- 19 who were previously not cardiac patients. For some the strain of having COVID-19 has caused them to have heart attacks or strokes, or they have lasting inflammation in their heart or a heart weakened by the virus.

They are not necessarily people you would think of as having heart problems, Wang said. One patient is a man in his 20s who Wang said “barely made it.” Now his heart is 10% weaker.

“There is early evidence that some of the COVID patients with cardiac complications are more likely to have serious complications down the road,” he said. “We don’t know what they will look like in five years. It’s too early to tell.”