Cardiovascular Mortality Rates Increased From 2020 to 2022, Correlating With Pandemic

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Investigators also found that the mortality rates for cardiovascular disease from 2020 to 2022 reversed the improvements of reduced mortalities in the preceding decades.

The increased mortality rate due to cardiovascular disease (CVD) that began in 2020 continued, according to findings of an analysis published in the American Journal of Preventive Medicine.1,2 According to a press release, this reverses the improvements of reduced mortalities from heart disease and stroke in the decades preceding the COVID-19 pandemic.2

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“We were concerned about the emerging evidence that chronic disease outcomes worsened during the first 2 years of the COVID-19 pandemic. This was unfortunately the case with heart disease and stroke, which had been improving before the pandemic. We wanted to understand whether the concerning trends were temporary or whether they continued through 2022,” Rebecca C Woodruff, PhD, MPH, from the division for heart disease and stroke prevention, part of the national center for chronic disease prevention and health promotion for the CDC, said in the press release.2

3 Key Takeaways

  1. Before the COVID-19 pandemic, death rates from CVD had shown a steady decline. However, the study found a reversal in this trend, indicating an increase in CVD mortality rates starting in 2020.
  2. The decline observed from 2010 to 2019, amounting to an 8.9% decrease in age-adjusted mortality rates (AAMR), was followed by a 9.3% increase in AAMR from 2019 to 2022, with an average annual percentage increase of 2% during 2020 to 2022.
  3. Subgroups such as adults aged 35 to 54 years, 65 to 74 years, and 85 years and older, as well as males, females, White adults, and Black adults, exhibited CVD AAMR in 2022 that approximated or exceeded levels observed in 2010.

According to the study authors, death rates from CVD declined steadily prior to the COVID-19 pandemic. Investigators had 2 aims of the study: to determine what the trends for CVD mortality rates showed regarding adults aged 35 years and older from 2010 to 2022; and to estimate the excess deaths from CVD from 2020 through 2022 compared to the expected deaths, which were predicted from the trends of 2010 to 2019, according to the study authors.1

Investigators used data from the National Vital Statistics System, part of the National Center for Health Statistics. Data were assessed using the CDC’s Wide-ranging Online Data for Epidemiologic Research platform, aggregating death certificate data in all 50 states and the District of Columbia, according to the study investigators.1

The mortality data were used to calculate the age-adjusted mortality rates (AAMR) per 100,000 population deaths, according to the study investigators. Deaths from CVD heart disease and stroke were also included as secondary outcomes.1

The study authors reported a total of 10,951,403 CVD deaths for adults aged 35 years and older between 2010 and 2022. Most deaths occurred from 2010 to 2019, although approximately 25.3% occurred from 2020 to 2022, according to the study investigators. Approximately 75.6% were deaths from heart disease while 16.9% were from stroke and 7.5% were from other CVD factors.1

Investigators found that the CVD AAMR declined by 8.9% from 2010 to 2019, but increased by 9.3% from 2019 to 2022, with an average annual percentage increase of 3% from 2020 to 2022, according to the results of the study. The study authors said the last time the national CVD AAMR was observed at the same level was between 2010 and 2011.1

The results showed a similar trend of declining AAMR in 2010 to 2019, then reversing from 2019 to 2022 in adults of all sex, race, and Hispanic ethnicity groups. The investigators reported the trend was driven by older adults aged 65 years and older. Adults aged 35 to 54 years, 65 to 74 years, and 85 years and older, males, females, White adults, and Black adults, all analyzed as subgroups, correlated with 2022 CVD AAMR that approximated or exceeded the AAMR in 2010, according to the study investigators.1

Investigators found that 9% more deaths occurred than expected during 2020 to 2022, with the greatest subgroups being adults aged 35 to 54 years, adults aged 75 to 84 years, Black adults, and those who were Asian or Pacific Islander.1

“Research to understand the drivers of these increases in CVD mortality rates can help guide clinical and public health approaches to prevent, detect, and treat CVD. Reprioritizing prevention and management of CVD is an essential first step,” Woodruff said in the press release. “The magnitude of the setbacks in CVD mortality and the range of affected subgroups speak to the need for broader prevention efforts moving forward.”2

Reference

  1. Woodruff RC, Tong X, Khan SS, Jackson SL, et al. Trends in Cardiovascular Disease Mortality Rates and Excess Deaths, 2010-2022. Am J Prev Med. 2023. doi:10.1016/j.amepre.2023.11.009
  2. Post pandemic, US cardiovascular death rate continues upward trajectory. News release. Elsevier. January 24, 2024 Accessed February 2, 2024. https://www.elsevier.com/about/press-releases/post-pandemic-us-cardiovascular-death-rate-continues-upward-trajectory
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