American Heart Association Report Predicts COVID-19 Effects on Cardiovascular Disease Burden

The American Heart Association’s (AHA) 2021 Statistical Update reported that heart disease remains the leading cause of death worldwide, and coronavirus disease 2019 (COVID-19) may have an impact on cardiovascular health and mortality rates for years to come.¹

Published in its journal Circulation, the Heart Disease and Stroke Statistical Update showed that the global pandemic will likely have considerable and lasting effects on cardiovascular disease (CVD) rates and disease burden.

Experts warned that CVD rates and mortality may grow exponentially in the years ahead. “COVID-19 has taken a huge toll on human life worldwide and is on track to become one of the top 3 to 5 causes of death in 2020. But its influence will directly and indirectly impact rates of cardiovascular disease prevalence and deaths for years to come,” said Salim S. Virani, MD, PhD, FAHA, chair of the writing committee for the 2021 Statistical Update and an associate professor in cardiology and cardiovascular research sections at Baylor College of Medicine in Houston, Texas.

Notably, the COVID-19 pandemic has enabled unhealthy behaviors that are known to exacerbate the risk of CVD, including poor eating habits, increased alcohol consumption, and reduced physical activity, as well as the mental toll amid social isolation and the fear of contracting, or spreading, the virus. “We’ll need to watch and address these trends as the full ramifications will likely be felt for many years to come,” Virani said.

The AHA, the CDC, the National Institutes of Health (NIH) compile US data and the Global Burden of Disease Study from the Institute for Health Metrics and Evaluation at the University of Washington provides global data on the latest statistics on core health behaviors – smoking, physical activity, diet, and weight – and health factors that inform cardiovascular health, including cholesterol, blood pressure, and glucose control.

The statistics update reported that in 2018, CVD was the leading cause of death in the US (42.1%), followed by stroke (17.0%), high blood pressure (11.0%), heart failure (9.6%), diseases of the arteries (2.9%), and other CVD (17.4%). Globally, CVD is also the leading cause of death, accounting for an estimated 18.6 million deaths in 2019.²

The costs related to CVD are also substantial; between 2016 and 2017, direct and indirect costs of COVD were $363.4 billion, with $216 billion in direct costs, and $147.4 billion in lost productivity/mortality.²

The report additionally details factors revealing health inequities related to the social determinants of health (SDoH). In the US, data from 2015 to 2018 showed that 58.8% of non-Hispanic (NH) Black females and 60.1% of NH Black males had some form of CVD. The prevalence of prediabetes was also higher in NH Black adolescents (21.0%) and Hispanic adolescents (22.9%) than in NH whites (15.1%). ³

In the US, 34.2% of children aged 2 to 19 years were overweight or obese, according to data from 2013 to 2016. Data from the same time frame showed that 69.9% of US adults over the age of 20 were overweight or obese; 38.3% were obese.³

For the first time, the report dedicated a chapter on adverse pregnancy outcomes. In the US, cardiovascular deaths are the most common cause (26.5%) of maternal death. Ten percent to 20% of US pregnancies have included complications such as hypertensive disorders, gestational diabetes, preterm births, and small for gestational age at birth.

The report is a useful resource for the public, legislators, health care professionals and administrators, researchers, and advocates, Virani said.

References

1. Heart disease #1 cause of death rank likely to be impacted by COVID-19 for years to come. News Release. American Heart Association; January 27, 2021. Accessed January 28, 2021. https://newsroom.heart.org/news/heart-disease.
2. 2021 Heart Disease and Stroke Statistics Update Fact Sheet At-a-Glance. American Heart Association; 2021. Accessed January 28, 2021. https://www.heart.org/-/media/phd-files-2/science-news/2/2021-heart-and-stroke-stat-update/2021_heart_disease_and_stroke_statistics_update_fact_sheet_at_a_glance.pdf?la=en.
3. 2021 Heart Disease & Stroke Statistical Update Fact Sheet Blacks & Cardiovascular Disease. American Heart Association; 2019. Accessed January 28, 2021. https://www.heart.org/-/media/files/about-us/statistics/blacks-ucm_505477.pdf?la=en.