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The annual pace of Americans dying from cardiovascular-related causes accelerated during the first year of the COVID-19 pandemic to the worst it has been since 2015, according to final figures gathered this month by the American Heart Association.

In 2020, 928,741 deaths in the U.S. were blamed on cardiovascular issues, like heart disease and stroke. The age-adjusted rate of deaths also increased that year for the first time in a decade.

“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,” Dr. Michelle Albert, the association’s vice president, said in a news release announcing the annual publication compiled by the association and the National Institutes of Health.

Heart disease again made up the largest share of these deaths in 2020, at 41.2%, followed by stroke at 17.3%. 

The report just adds to the evidence of the wide-reaching toll the first year of the COVID-19 pandemic took on Americans’ health and longevity. Earlier findings from the Centers for Disease Control and Prevention had tallied the rate of heart disease deaths worsening across every demographic group for 2020.

“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 had said in a statement.

However, not every part of the country had been seeing rates consistently improve before the pandemic setback.

From 2011 to 2019, the CDC’s National Center for Health Statistics counted age-adjusted heart disease death rates decreasing in only 15 states. Arkansas saw an increase and others saw rates plateau.

Wide disparities also persist between demographic groups. More than half of men in every racial and ethnic group had cardiovascular disease from 2017 through 2020, ranging from 51.2% of White men to 58.9% of Black men.

Black women had the highest rates of cardiovascular disease of any group, at 59.0%, compared to 44.6% of White women, 38.5% of Asian women, and 37.3% of Hispanic women.

Cardiovascular deaths also saw the biggest increases in 2020 among Asian, Black, and Hispanic people, the publication reported, appearing to mirror some of the hardest-hit communities in the early wave of the pandemic.

However, the heart association authors acknowledged this year’s report remains “demonstrably incomplete” in tracking the risk and mortality of cardiovascular issues. Rates do not exist for racial and ethnic subgroups, nor for American Indian and Alaska Native people.

“Mischaracterizing or erasing the diversity of populations threatens our ability to understand the sociocultural determinants that contribute to differences and disparities in health and disease, and to develop tailored strategies to improve the health of populations,” Dr. Nilay Shah and Dr. Yvonne Commodore-Mensah, two authors of the publication, wrote in a statement.

COVID-19 and the heart

Experts have long warned that common heart conditions, like coronary artery disease, were conclusively linked to raising a person’s risk of severe COVID-19 illness and death.

In turn, a COVID infection can also affect the cardiovascular system in a myriad of ways, ranging from damaging heart tissue to causing blood clots.

Studies have also pointed to concerning links between the pandemic and worsening risk factors that can underlie heart problems.

One study funded by the National Heart, Lung, and Blood Institute found blood pressure increased during the first year of the pandemic, after months of relatively unchanged readings.

COVID-19 also led to broad disruptions in medical care for routine issues. One study published by the CDC in June 2020 estimated 41% of adults had avoided medical care over COVID-19 concerns.

“This resulted in people presenting with more advanced stages of cardiovascular conditions and needing more acute or urgent treatment for what may have been manageable chronic conditions. And, sadly, appears to have cost many their lives,” said Albert.

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