COVID-19 caused surge in heart disease deaths in first year of pandemic: report

In 2020, COVID-19 led to the largest single-year increase in the number of individuals dying from cardiovascular disease since 2015 and exceeded the previous record set in 2003, according to a report by the American Heart Association (AHA) published today in Circulation.

Many people delayed getting care for all healthcare conditions in 2020, the first year of the pandemic, because of concerns about contracting the virus as well as hospitals and other providers focusing all efforts and resources on battling COVID-19. This led to lapses in preventive and routine care.

In addition, COVID-19 can cause inflammation of heart tissue and blood clots, directly worsening heart conditions.

The report found that 928,741 people died in 2020 from cardiovascular disease compared to 874,613 cardiovascular disease-related deaths in 2019. It tops the previous highest CVD death count of 910,000 set in 2003. Researchers from a large swathe of academic institutions volunteered to work on the AHA’s Heart Disease and Stroke Statistics — 2023 Update.

Connie Tsao, M.D., an assistant professor of medicine at Harvard Medical School and the chairperson of the Statistical Update, said in a press release that “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%.”

The age-adjusted mortality rate takes into account that in an aging population, cardiovascular disease deaths will likely rise. “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,” said Tsao. “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.”

In addition, the AHA report finds that people of color experienced a disproportionately larger number of deaths from cardiovascular disease compared to whites. Michelle Albert, M.D., a professor of medicine at the University of California, San Francisco, said this was “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.”

Individuals delaying care meant that when they finally had no choice, their cardiovascular disease had reached an advanced stage and they needed urgent treatment “for what may have been manageable chronic conditions. And, sadly, [that] appears to have cost many their lives,” Albert said.

Heart disease kills more people in the U.S. than any other condition. It includes coronary heart disease, stroke, heart failure and hypertension/high blood pressure. It clogs arteries, and that causes heart attacks.

And though data were gathered about some racial and ethnic minorities, more needs to be done to find out how cardiovascular disease impacts other disparate groups, according to Tsao.

“This year’s writing group made a concerted effort to gather information on specific social factors related to health risk and outcomes, including sexual orientation, gender identity, urbanization and socioeconomic position,” Tsao said. “However, the data are lacking because these communities are grossly underrepresented in clinical and epidemiological research. We are hopeful that this gap in literature will be filled in coming years as it will be critical to the American Heart Association’s goal to achieve cardiovascular health equity for all in the U.S. and globally.”