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Heart Disease Deaths Spiked During COVID After 10-Year Decline

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Annual deaths from heart disease in the United States rose in 2020 during the COVID pandemic, after a steady decline over the previous decade, a new study shows.

The death rate from heart disease in the overall population recovered in 2020 to what it had been in 2015 — effectively negating 5 years of progress, researchers report.

The increase in mortality rates was even greater in non-Hispanic black patients and in younger adults ages 35 to 74 — a loss of 10 years of progress.

Rebecca C. Woodruff, PhD, MPH, presented these findings at the American Heart Association (AHA) 2022 Scientific Sessions.

Through better detection and treatment of cardiovascular risk factorsdeaths from heart disease in the United States have been declining for decades, and the decline from 1900 to 1999 “has been recognized as a peak public health achievement of the 20th centuryWoodruff, an epidemiologist at the National Center for Chronic Disease Prevention and Health Promotion, told Centers for Disease Control and Prevention (CDC), theheart.org | Medscape Cardiology.

The reversal of this trend during the first year of the pandemic is likely due to many factors, she said. For example, the pandemic has disrupted access to healthcare for many people, potentially leading to delays in detecting and treating heart disease. The pandemic “might have made it harder for people to do the things we know prevent heart disease,” she noted.

Furthermore, new evidence suggests that people who have had COVID-19 are at increased risk of new or worsening cardiovascular disease.

Non-Hispanic black patients and younger adults may be more exposed to COVID-19 in their workplace, less financial stability, more stress and more limited access to health care.

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The study results “underscore the importance of continued detection and treatment of both acute and chronic heart disease,” Woodruff said, and of “advising patients about the importance of improving their cardiovascular health by monitoring the Life’s Essential of the American Heart Association 8 – eat better, be more active, stop smoking, sleep soundly, control weight, control cholesterol, control blood sugar and control blood pressure.

“COVID-19 vaccines can help anyone, especially those with underlying heart disease or other health conditions, protect themselves against severe COVID-19,” she added. And “prioritizing equitable access to quality health care can help adults prevent and manage heart disease, reduce disparities in heart disease mortality, and improve outcomes.”

“Landmark Study” a wake up call

“Virtually all clinicians are well aware of the remarkable, ongoing decline in mortality from heart disease in the US population that has occurred over the past several decades,” said Andrew J. Einstein, MD, PhD, who was not involved in this study. until theheart.org | Medscape Cardiology.

“This groundbreaking epidemiological study … has identified two deeply troubling changes in this downward trend that should concern all clinicians,” said Einstein, professor of medicine and director of nuclear cardiology, cardiac CT and cardiac MRIat Columbia University Irving Medical Center in New York City.

First, in 2020, the first year of the pandemic, there was a sharp rise in adult deaths from heart disease, affecting all segments of the US population. Second, there were striking differences between demographic groups, and this turnaround that was underway mostly affected black adults and younger adults.

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The findings highlight “the importance of redoubling efforts to ensure that all adults, but especially black people and youth, are connected to the health care system and receive quality care to ensure that optimal attention is paid to disease prevention, cardiovascular healthy living, management of risk factors, timely diagnosis and treatment, and making up for missed care during the first year of the pandemic,” said Einstein.

“It is clear that the findings of this important study should serve as a wake-up call,” he said, “as we have slipped back many years of progress.”

Clinicians should reach out to re-establish the healthcare provider-patient bond with patients they have lost during the pandemic, and ensure that all patients close the gaps in care that have arisen in a timely manner, he continued. “This is especially critical for our black and younger patients.”

“Let’s hope 2020 was an aberration, and the introduction of COVID vaccination, advancements in COVID treatment, the evolution of the virus towards less lethal strains, and the reopening of society in 2021 and beyond all lead to a strong upturn in patient numbers.” involvement in and measures of cardiovascular health,” he said.

“But we need to collect and evaluate the relevant data, across all aspects of heart care, without actively establishing programs to engage patients and populations in heart health promotion efforts.”

National study

For this analysis, the researchers obtained age-adjusted annual death rates from heart disease from 2010 to 2020 from the CDC’s WONDER database.

They identified adults aged 35 and older with heart disease as the cause of death, based on International Classification of Diseases, 10th revision codes.

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They found that:

  • The age-adjusted number of deaths from heart disease per 100,000 adults decreased each year from 2010 to 2019 and increased in 2020 – overall, and in men, in women, across all age groups (35 to 54, 55 to 74, and 75+). and among all racial and Hispanic ethnicity groups.

  • Overall, deaths from heart disease fell by 9.8% (from 347.3 to 313.0 per 100,000 adults) from 2010 to 2019, but increased by 4.1% (to 325.9 per 100,000 adults) in 2020, which was about the same as in 2015 (325.6 per 100,000 adults).

  • Among non-Hispanic blacks, deaths from heart disease fell 10.4% from 2010 to 2019, but increased by 11.2% to 440.7 per 100,000 in 2020, which was about the same rate as in 2010 (442.4 per 100,000).

  • Among adults aged 35 to 54, deaths from heart disease fell 5.5% from 2010 to 2019 and increased 12.0% in 2020, which was higher than in 2010 (54.1 versus 51.1 per 100,000).

  • Among adults aged 55 to 74, deaths from heart disease decreased by 2.3% from 2010 to 2019 and increased by 7.8% in 2020, which was higher than in 2010 (297.3 vs. 282.5 per 100,000).

  • In 2020, about 7 years of progress in declining cardiac death rates were lost in men and 3 years of progress in women.

The authors and Einstein have no relevant financial disclosures.

American Heart Association (AHA) 2022 Scientific Sessions. Abstract VP161.

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