People dying from cardiovascular disease up by 6.2% in US, says study

The number of people dying from cardiovascular disease (CVD) in the US escalated during the first year of the COVID-19 pandemic by 6.2 per cent, according to a study.

The rise in the number of CVD deaths in 2020, from 874,613 CVD-related deaths recorded in 2019 to 928,741 in 2020, represents the largest single-year increase since 2015 and topped the previous high of 910,000 recorded in 2003, according to the latest available data from the Heart Disease and Stroke Statistics - 2023 Update of the American Heart Association, a global force for healthier lives for all, the study said.

The study has been published in the journal Circulation.

"While the total number of CVD-related deaths increased from 2019 to 2020, what may be even more telling is that our age-adjusted mortality rate increased for the first time in many years and by a fairly substantial 4.6 per cent," said the volunteer chair of the Statistical Update writing group Connie W. Tsao, an assistant professor at Harvard Medical School, US.

"The age-adjusted mortality rate takes into consideration that the total population may have more older adults from one year to another, in which case you might expect higher rates of death among older people.

"So even though our total number of deaths have been slowly increasing over the past decade, we have seen a decline each year in our age-adjusted rates - until 2020.

"I think that is very indicative of what has been going on within our country - and the world - in light of people of all ages being impacted by the COVID-19 pandemic, especially before vaccines were available to slow the spread," said Tsao.

The biggest increases in the overall number of CVD-related deaths were seen among Asian, Black and Hispanic people, populations most impacted in the early days of the pandemic, and brought to focus increasing structural and societal disparities.

"We know that COVID-19 took a tremendous toll, and preliminary data from the US Centers for Disease Control and Prevention (CDC) have shown that there was a substantial increase in the loss of lives from all causes since the start of the pandemic.

"That this likely translated to an increase in overall cardiovascular deaths, while disheartening, is not surprising. In fact, the Association predicted this trend, which is now official," said the American Heart Association's volunteer president, Michelle A. Albert, a professor at the University of California at San Francisco (UCSF), US.

"COVID-19 has both direct and indirect impacts on cardiovascular health. As we learned, the virus is associated with new clotting and inflammation.

"We also know that many people who had new or existing heart disease and stroke symptoms were reluctant to seek medical care, particularly in the early days of the pandemic.

"This resulted in people presenting with more advanced stages of cardiovascular conditions and needing more acute or urgent treatment for what may have been manageable chronic conditions. And, sadly, appears to have cost many their lives," said Albert.

According to Albert, the larger increases in the number of coronary heart disease deaths among adults of Asian, Black and Hispanic populations appear to correlate with the people most often infected with COVID-19.

"People from communities of colour were among those more highly impacted, especially early on, often due to a disproportionate burden of cardiovascular risk factors such as hypertension and obesity.

"Additionally, there are socioeconomic considerations, as well as the ongoing impact of structural racism on multiple factors including limiting the ability to access quality health care," Albert said.

Cardiovascular disease, overall, includes coronary heart disease, stroke, heart failure and hypertension/high blood pressure. Coronary heart disease includes clogged arteries or atherosclerosis of the heart, which can cause a heart attack.

Known generally as 'heart disease', coronary heart disease remains the #1 cause of death in the US. Stroke continues to rank fifth among all causes of death behind heart disease, cancer, COVID-19 and unintentional injuries/accidents.

COVID-19 appeared in the list of leading causes of death for the first time in 2020, the most recent year for which final statistics are available from the US CDC, the study said.

Appropriately, this year's statistical update includes many references to COVID-19 and its impact on cardiovascular disease. Data points and scientific research findings are inserted throughout most chapters of the document, including those related to the risk factors for heart disease and stroke such as obesity, diabetes and high blood pressure, all of which also put people at increased risk for COVID. Many of the studies noted identify specific gender, race and ethnicity disparities.