COVID-19 Reminds Us How Vital Knowledge And Treatment Of Patients’ Autonomic Nervous System Abnormalities Are In Cardiovascular Disease

Introduction. The immune (inflammatory) and autonomic interaction critically affects development and progression of adult cardiovascular disease (CVD) and is unnecessarily under-appreciated and untreated, since the technology to accurately diagnose and effectively treat Parasympathetic (P) and Sympathetic (S) abnormalities is available. Focus. This a review of our publications regarding COVID-19 immune-P&S interactions and CV complications and suggested therapy based upon improved outcomes associated with improved P&S status in systemic hypertension (HTN), coronary artery disease (CAD), congestive heart failure (CHF), and neurogenic orthostatic hypotension (NOH). The results are: 1) P&S dysfunction likely determines the severity of COVID-19 CV complications; 2) Sympathovagal Balance (SB= resting S/P) >2.5 best noninvasively predicts Major Adverse Cardiac Events (MACE=sudden/non-sudden cardiac death, acute coronary syndromes (ACS), acute CHF, ventricular tachycardia/fibrillation (VT/VF) (p0.10 bpm2 (CAN/AAD) reduces sudden cardiac death (SCD) in adult diabetes mellitus (DM II) (RRR=43%, p=0.0076) using (r)alpha lipoic acid (ALA); 4) tailoring HTN treatment to P&S activity more than doubles treatment goal achievement to 74% by 8.35 months on less medicine compared to standard therapy (e.g., JNC 8; p