COVID pandemic caused cardiovascular deaths to rise sharply

A recent report by the American Heart Association published in the journal Circulation reported the updated statistics on the major circulatory and cardiovascular diseases, and their outcomes for 2023, with additional insights into the trends in heart disease during the coronavirus disease 2019 (COVID-19) pandemic.

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association. Image Credit: Kateryna Kon / Shutterstock

Background

The annual report by the American Heart Association in association with other government agencies, including the National Institutes of Health, presents the most recent statistics on cardiovascular disease risk factors relating to the American Heart Association’s Life’s Essential Eight, which comprises health behaviors such as diet, physical activity, weight, and smoking, and other contributive health factors such as cholesterol, glucose levels, and blood pressure. This report is an essential resource for healthcare professionals and policymakers, health advocates, researchers, and the general public seeking updated and reliable information on cardiovascular health.

Major findings

The American Heart Association report indicated that cardiovascular diseases accounted for 928,713 deaths in 2020, with 580,994 below the age of 85. The proportion of male and female mortalities was approximately similar. The mortalities due to heart disease in 2020 were 696,937, with more than 400,000 cases in individuals below the age of 85.

Between 2013 and 2020, the overall cardiovascular health scores based on the Life’s Essential eight components were 73.6 for children in the United States (U.S.) between the ages of 16 and 19, and 65.2 for adults. Increased cardiovascular health scores were associated with an increase in life expectancy by 5.5 years for males and 4.2 years for females. However, the average life expectancy at birth decreased from 78.8 years to 77 years between 2019 and 2020 due to the over one million COVID-19-related deaths. The cumulative COVID-19-related mortality rate was approximately 292 per 100,000 people in metropolitan areas and 392 per 100,000 people in non-metropolitan areas in the U.S.

While on average, cigarette use had declined among the youth and adult populations in the U.S., 2020 saw a higher prevalence of tobacco use among the Alaskan Native, American Indian, gay, lesbian, and bisexual adults as compared to White and heterosexual adults. The report also indicated that in 2019 and 2020, only 20.6% of youths between the ages of 6 and 17 were active for more than 60 minutes per day. According to the self-reported statistics in 2018, 54.2% of adults achieved the physical activity guidelines of more than 150 minutes of moderate physical activity or more than 75 minutes of vigorous physical activity per week.

According to the Life Essential scores, diet or nutrition was one of the four areas with the lowest scores, ranging between 23.8 and 47.7 across different demographic groups. Among children between the ages of two and five and between 12 and 19 years, the diet scores were 61.1 and 28.5, respectively. However, the prevalence of being overweight was 36.8%, and obesity was prevalent in 19.8% of U.S. adolescents and children between the ages of two and 19. The highest prevalence was observed among Hispanic male and non-Hispanic Black female youth. Among adults above the age of 20, the prevalence of being overweight or obese was 71.2% and 41.4%, respectively.

Between 2017 and 2020, increased low-density lipoprotein cholesterol (LDL-C) levels occurred in 5% of adolescent males and 4.6% of adolescent females, while among adults, 25.6% of males and 25.4% of females had high levels of LDL-C. In addition, among U.S. adults above the age of 20, hypertension was prevalent in 50.4% of males and 43% of females, translating to 122.4 million adults with high blood pressure in the U.S. between 2017 and 2020.

Additionally, based on 2017–2020 data, close to 29.3 million adults were diagnosed with diabetes in the U.S. Peripheral artery disease was seen to be the most common (16.2%) and early diabetes-related cardiovascular complication, followed by heart failure (14.1%), angina (11.9%), non-fatal myocardial infarction (11.5%), and stroke (10.3%).

The prevalence of cardiovascular diseases comprising coronary heart disease, heart failure, hypertension, and stroke among U.S. adults above the age of 20 between 2017 and 2020 was 48.6%. The 2020 mortality data suggested that heart disease and stroke caused more deaths than lower respiratory diseases and cancer. The global mortality rates for cardiovascular diseases saw an 18.71% increase between 2010 and 2020.

Conclusions

Overall, the comprehensive report by the American Heart Association with the updated statistics on heart disease and stroke is a detailed resource for healthcare professionals, policymakers, researchers, and interested citizens on a wide range of cardiovascular disease prevalence and mortality rates, risk factors, associated outcomes, as well as other serious health conditions such as renal and metabolic diseases.