AHA’s 2023 Statistical Update reports largest increase in CVD deaths in US

Cardiovascular disease (CVD) deaths in the United States increased from 874,613 CVD-related deaths recorded in 2019 to 928,741 in 2020 in the first year of the COVID-19 pandemic . Increase in CVD deaths in 2020 Represents the largest one-year increase since 2015, surpassing the all-time high of 910,000 recorded in 2003, according to the latest data available from Heart Disease and Stroke Statistics . The 2023 update from the American Heart Association, the global force for healthier lives for all, was published today in the association’s leading peer-reviewed journal. circulation.

Total CVD deaths increased from 2019 to 2020, but more importantly, the age-adjusted mortality rate increased by 4.6% for the first time in years. Age-adjusted mortality rates take into account the potential increase in older people in the total population from year to year. In this case, one might expect higher mortality among the elderly. Thus, while the total death toll has been slowly increasing over the past decade, the age-adjusted mortality rate has been declining annually until 2020. Especially in light of people of all ages affected by the COVID-19 pandemic, before a vaccine slows its uptake.”

Connie W. Tsao, MD, MPH, FAHA, Volunteer Chair of the Statistical Update Writing Group, Assistant Professor of Medicine, Harvard Medical School, Staff Cardiologist, Beth Israel Deaconess Medical Center in Boston

The largest increase in overall CVD-related deaths was seen among the Asian, Black, and Hispanic populations most affected early in the pandemic, highlighting widening structural and social disparities.

“We know that COVID-19 has wreaked havoc, and preliminary data from the U.S. Centers for Disease Control and Prevention (CDC) shows a significant increase in deaths from all causes since the start of the pandemic. It is disappointing but not surprising that this is likely to lead to an increase in overall cardiovascular deaths. “COVID-19 has direct and indirect effects on cardiovascular health. As we have learned, the virus is associated with new clotting and inflammation.” We also know that many people with new or existing symptoms of heart disease or stroke were reluctant to seek medical care, especially early in the pandemic. It presents at a more advanced stage, requiring more acute or emergency treatment for what may have been a manageable chronic disease. .

According to Albert, director of UCSF’s Adversity and Cardiovascular Disease Research Center (NURTURE Center) and a prominent leader in health equity and adversity research, the increasing number of deaths from coronary heart disease in adults is Larger numbers of Asian, Black, and Hispanic populations appear to be correlated with those most frequently infected with COVID-19.

“People from communities of color were among those more affected, especially early on, due to their disproportionate burden of cardiovascular risk factors such as hypertension and obesity. There are multiple factors, including significant considerations and limiting access to quality health care,” said Albert. “The American Heart Association responded quickly in the early days of the pandemic to address the impact of COVID-19 and focus on equitable health for all. Launched the first-ever rapid response research grant to seek to turn around science; establish COVID-19 CVD hospital registries through the Get With The Guidelines® quality initiative; We have made an unprecedented commitment to proactively address social determinants while working to improve…saving lives.”

Cardiovascular disease in general includes coronary heart disease, stroke, heart failure, and hypertension/hypertension. Coronary heart disease includes clogged arteries and atherosclerosis of the heart that can lead to heart attacks. Coronary heart disease, commonly known as “heart disease,” remains the number one cause of death in the United States. Stroke continues to rank fifth among all causes of death, behind heart disease, cancer, COVID-19 and unintentional injury/accidents. COVID-19 entered the list of leading causes of death for the first time in 2020. This is the latest year for which final statistics are available from the US Centers for Disease Control and Prevention (CDC).

Fittingly, this year’s statistical update includes many references to COVID-19 and its impact on cardiovascular disease. Data points and scientific research findings are inserted into most chapters of the document, including those related to heart disease and stroke risk factors such as obesity, diabetes, and high blood pressure, all of which put people at his COVID risk. exposed to Many of the studies noted identify specific gender, racial, and ethnic disparities.

But disparities don’t just occur between age, gender and racial/ethnic groups, according to a special commentary created by members of the Statistical Update writing committee. Statistical Update has included a range of social determinants of health data in its report, but in its commentary, LGBTQ people and other underrepresented groups, such as those living in rural and urban areas of the United States, data are still lacking. Commentary authors point to the lack of scientific research and cumulative data on the impact of social identity and social determinants.

“We know that addressing discrimination and disparities that affect health requires a better awareness and understanding of the unique experiences of individuals and groups. We worked collaboratively to gather information on specific social factors related to and outcomes: sexual orientation, gender identity, urbanization, and socioeconomic status,” said Zhao. “However, these communities have been severely underrepresented in clinical and epidemiological studies, and data are scarce. We hope that this gap in the literature will be filled in the coming years. because it is important to the American Heart Association’s goal of achieving health equity for all, all in the United States and around the world.”

global data

Cardiovascular disease claims the lives of more than 19 million people worldwide each year, killing people of all ages, genders and nationalities. However, the risk factors that cause heart disease and stroke continue to disproportionately affect certain populations, not just in the United States, but around the world.

A supplementary table to this year’s statistical update examines global and regional trends in overall CVD-related deaths, and also presents the number and proportion of deaths from various cardiovascular diseases. In addition, the Supplementary Table compared all-cause mortality and his CVD-related mortality attributed to different risk factors and age-standardized disability-adjusted life years (DALYs) in different countries and regions. Notices:

• Globally, ischemic heart disease and stroke are the top two causes of CVD-related deaths, accounting for 16.2% and 11.6% of all deaths, respectively. These percentages have increased worldwide over the last decade in all but her two regions of North America and Europe/Central Asia. Note that ischemic heart disease is the term used in global data sources, also known as coronary heart disease.
• In 1990, ischemic heart disease accounted for 28.2% of all deaths in North America, but in 2019 it decreased to 18.7% of all deaths.
• In the Europe and Central Asia region, ischemic heart disease decreased from 27.2% of all deaths in 1990 to 24.4% in 2019, and stroke accounted for 15.1% of all deaths in 1990, up from 12.5% ​​in 2019. %.
• East Asia and the Pacific is the only region where stroke has the highest rate of CVD-related deaths, increasing from 14.8% in 1990 to 18.3% in 2019. During this same period, the proportion of deaths attributable to ischemic heart disease nearly doubled, from 8.1% to 15.6%.
• We noted that sub-Saharan Africa has the lowest proportion of CVD-related deaths among all causes of death. Stroke was the leading cause of his CVD-related deaths in sub-Saharan Africa in 1990, accounting for his 3.6% of all causes, followed by ischemic heart disease (3.1%). Ischemic heart disease and stroke were both responsible for 5.4% of all deaths in 2019.

“As the United States prepares to celebrate its 60th anniversary,^th The annual Heart Month of February 2023 will identify and remove barriers that put certain people at disproportionately high risk, while highlighting the lives they have achieved in nearly a century of research, advocacy and education. It is important to recognize and multiply saving progress. “Tracking such trends is one of the reasons the American Heart Association publishes this definitive statistical update each year, providing the latest data, relevant scientific findings, and national cardiovascular disease data. provides a comprehensive resource for assessing the impact of global

Annual updates compile the latest and most relevant statistics on heart disease, stroke and risk factors affecting cardiovascular health. Track trends related to ideal cardiovascular health, social determinants of health, global cardiovascular health, cardiovascular health genetics, and healthcare costs. Mr. Tsao is important to the public, policy makers, media professionals, clinicians, medical administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions. As a resource, we emphasized the importance of this oversight.

This statistical update was prepared by a volunteer writing group on behalf of the American Heart Association Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.