Spike in heart-related deaths tied to early pandemic

The number of people dying from cardiovascular disease in the U.S. spiked during the first year of the COVID-19 pandemic, marking the steepest single-year increase since 2015, according to a new report from the American Heart Association.

In 2020, there were 928,741 deaths related to heart disease, stroke and high blood pressure — marking a substantial increase from the 874,613 fatalities linked to cardiovascular disease (CVD) in 2019. The latest figure also tops the previous record of 910,000 from 2003, based on the data published Wednesday in the peer-reviewed journal Circulation.

“COVID-19 has both direct and indirect impacts on cardiovascular health. As we learned, the virus is associated with new clotting and inflammation. We also know that many people who had new or existing heart disease and stroke symptoms were reluctant to seek medical care, particularly in the early days of the pandemic,” Dr. Michelle A. Albert, the association’s president and a professor of medicine at UCSF, said in a news release.

Cathy Lewis, a spokesperson for the American Heart Association, said comprehensive figures to show whether the trend continued in 2021 and 2022, as vaccines became widely available and restrictions relaxed, would not be available until next year.

Heart disease remains the leading cause of death in the U.S., followed by cancer, COVID-19, unintentional injuries/ accidents and stroke, according to the most recent figures from the Centers for Disease Control and Prevention.

The latest figures show that the effects of the pandemic reversed years of progress.

“Prior to 2020, death rates from heart disease had been declining among adults for decades, which has been recognized by the CDC as one of the ten greatest public health achievements of the last century,” the CDC’s Rebecca Woodruff said in a statement in October.

The highest increases in the overall number of cardiovascular-related deaths in 2020 were among Asian, Black and Hispanic people, according to the report — communities disproportionately impacted in the early days of the pandemic.

“People from communities of color were among those more highly impacted, especially early on, often due to a disproportionate burden of cardiovascular risk factors such as hypertension and obesity,” Albert said. “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.”

The authors said that the numbers in this year’s report were likely an undercount due to a lack of data from other underrepresented populations, such as LGBTQ people and people living in rural areas.

“While the total number of CVD-related deaths increased from 2019 to 2020, what may be even more telling is that our ageadjusted mortality rate increased for the first time in many years and by a fairly substantial 4.6%,” said Connie W. Tsao, an assistant professor of medicine at Harvard Medical School and attending staff cardiologist at Beth Israel Deaconess Medical Center in Boston.

She added, “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.”