According to the American Heart Association, cardiovascular disease claims more lives each year in the U.S. than all forms of cancer and chronic lower respiratory disease combined. However, advances in treatment and preventative medicine, as well as education about heart healthy lifestyle choices, had seen a steady decline in deaths due to heart disease during the past three decades. This trend marked a success story of note, but it saw a setback in 2020 due to the arrival of the COVID-19 pandemic.
In a presentation at the American Heart Association’s Scientific Sessions 2022, being held November 5–7 both virtually and in Chicago, researchers have compared the national death rate from heart disease during 2020 with the death rates during the period 2010–2019. They did this by accessing the age-standardized death rates per 100,000 population from the U.S. Centers for Disease Control and Prevention’s WONDER database, which aggregates death certificate data from the National Vital Statistics System.
Their analysis, presented during the AHA’s meeting, found that heart disease death rates increased in 2020, across adults in all age, sex, race and ethnicity groups, particularly among younger adults and non-Hispanic Black adults.
“Prior to 2020, death rates from heart disease had been declining among adults for decades, which has been recognized by the CDC as one of the ten greatest public health achievements of the last century,” said lead study author Rebecca C. Woodruff, Ph.D., M.P.H., an epidemiologist at the Centers for Disease Control and Prevention (CDC). “The increases in death rates from heart disease in 2020 represented about 5 years of lost progress among adults nationwide and about 10 years of lost progress among younger adults and non-Hispanic Black adults,” she added.
The spread of COVID-19 in the U.S. began prompting school and workplace closures in some states in February 2020. It was declared a global pandemic by the World Health Organization the following month and stay-home orders were widespread. The first COVID-19 vaccinations for adults and some teens were available in December 2020.
“The COVID-19 pandemic disrupted many aspects of daily life, including access to preventive health care, which may have led to delays in detecting and treating heart disease,” Woodruff said. “We expected to see an increase in heart disease death rates among adults, however the magnitude of the increase was striking.”
In particular, the researchers found that, whereas the national heart disease rate among adults decreased by 9.8 percent between 2010 and 2019, it increased by 4.1 percent in 2020. This reversal represents about five years of lost progress in reducing heart disease death rates among adults.
The findings were even more unsettling for younger adults. Among 35- to 54-year-old people, deaths from heart disease fell by 5.5 percent between 2010 and 2019, yet they jumped up by12 percent in 2020. This represents approximately ten years of lost progress. Among 55- to 74-year-old adults, heart disease death rates were down by 2.3 percent between 2010 and 2019, yet they increased by 7.8 percent in 2020.
In addition, increases in heart disease death rates were high among non-Hispanic Black adults, who experienced approximately ten years of lost gains. In this group, heart disease death rates declined by 10.4 percent between 2010 and 2019, then increased by 11.2 percent in 2020.
Although further investigation needs to be done, the researchers name several factors implicated in the reversals of the heart disease death rate trend during 2020. Lockdowns saw people exercising less and smoking and drinking alcohol more regularly, all of which contributed to the higher cardiovascular death rates, said American Heart Association President Michelle A. Albert, M.D., M.P.H., FAHA, the Walter A. Haas-Lucie Stern Endowed Chair in Cardiology and professor of medicine at the University of California at San Francisco. In addition, growing evidence suggests that people who have had COVID-19 infection may be at an increased risk for new or worsening cardiovascular disease.
“These social determinants of health have a larger effect on people who are economically disadvantaged – Black people, Hispanic people and Indigenous and Native individuals – so then you have a domino effect resulting in higher death rates and more disease among these populations,” Albert explained.
She urged action from both citizens and health care professionals. “If you are a person who has not received medical care for one or more years because of the pandemic, please seek out care from a health care professional. And it’s important for health care professionals to really take a look at their pool of patients to identify those persons who have dropped off their radar, and reach out to those people and offer medical assistance, as well as potentially connect them with the social resources that they might need now coming out of the pandemic.”
Woodruff added that the CDC is actively investigating heart disease trends after 2020 to see how the trends have changed since then. Meanwhile, there are steps to better manage cardiovascular disease risk going forward. Everyone can improve cardiovascular health by following the American Heart Association’s Life’s Essential 8: eat better, be physically active, do not smoke, get enough sleep, maintain a healthy weight, and control blood pressure, as well as levels of cholesterol and blood sugar.
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