CVD deaths undergo largest single-year increase since 2015

By Elissa Wolfson, The Science Advisory Board assistant editor

January 25, 2023 -- The American Heart Association's (AHA) report "Heart Disease and Stroke Statistics—2023 Update" outlines the most significant single-year increase in cardiovascular disease (CVD) deaths in the U.S. since 2015.

The report, published on January 25 in the journal Circulation, also noted that the largest increases in deaths were among Asian, Black, and Hispanic populations.

CVD comprises coronary heart disease, stroke, heart failure, and hypertension. Coronary heart disease includes clogged arteries or atherosclerosis, which can cause heart attacks. Globally, CVD continues to be the No. 1 killer, claiming more than 19 million lives each year.

During the first year of the COVID-19 pandemic, the number of Americans dying from CVD escalated from 874,613 in 2019 to 928,741 in 2020, which topped the previous high of 910,000 recorded in 2003.

Age-adjusted mortality rates also increased for the first time in many years, by a substantial 4.6%, indicating a global situation in which people of all ages were impacted by the COVID-19 pandemic, especially before vaccines became available.

The increased loss of lives from all causes since 2020 translated to an increase in cardiovascular deaths, both from direct causes -- such as the virus's association with new clotting and inflammation -- and indirect causes. The latter includes the many people with new or existing heart disease symptoms reluctant to seek medical care in 2020, then later presenting with more advanced cardiovascular conditions requiring urgent treatment for what might have previously been a manageable chronic condition.

Yet, the risk factors leading to heart disease and stroke continue to disproportionately affect certain populations. In the U.S., Asian, Black, and Hispanic adults are the most impacted, bringing structural and societal disparities into focus. The larger increases in CVD deaths among these populations correlate with the groups most often infected with COVID-19.

These high impacts on communities of color are often due to a disproportionate burden of cardiovascular risk factors such as hypertension, diabetes, and obesity, which also pose increased risks for COVID-19. Additional socioeconomic risk factors include limited access to quality healthcare.

Data from other underrepresented groups, such as the LGBTQIA population and rural area residents, are lacking. The report's authors note that addressing these concerns is critical to the AHA's goal of achieving cardiovascular health equity for all. While the pandemic will likely affect death rates for years to come, the lessons learned offer opportunities to address structural and societal issues that drive health disparities, according to the AHA.

"As the U.S. prepares to celebrate the 60th annual Heart Month in February 2023, it's critical that we recognize and redouble the life-saving progress we've made in nearly a century of researching, advocating, and educating, while identifying and removing those barriers that still put certain people at disproportionately increased risk for cardiovascular disease," Dr. Michelle Albert, the AHA's volunteer president, said in a statement.

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