Heart Disease Mortality Rates Rebounded to 2010-2015 Levels in 2020

The yearly decline in death due to heart disease (HD) in the United States (US) reversed in 2020 during the COVID-19 pandemic,  according to study results presented at the American Heart Association (AHA) Scientific Sessions 2022, held from November 5th through 7th, in Chicago, Illinois.

For decades, HD-related mortality rates in the US have been declining. This study, conducted by the US Centers for Disease Control and Prevention (CDC), was an update of 2010 to 2020 trends.

Data were sourced from the CDC’s WONDER database which aggregates death certificate data. Deaths from HD were defined using the International Classification of Diseases, 10th revision codes. Data from adults aged 35 years and older were reported.

Across age, gender, and ethnicity groups, the HD mortality rates declined by 9.8% from 347.3 per 100,000 in 2010 to 313.0 per 100,000 in 2019, but increased by 4.1% in 2020 to 325.9 per 100,000. The rate observed in 2020 was most similar to the rate seen in 2015 (326.5 per 100,000).

In 2020, coronary heart disease accounted for 55% of these HD deaths.

Stratified by ethnicity, the HD death rate among Black adults decreased by 10.4% from 2010 to 2019 and increased by 11.2% in 2020. These rates indicated that despite nearly a decade of decline, the death rate in 2020 rebounded to nearly the rate observed in 2010 (440.7 vs 442.4 per 100,000), respectively.

Stratified by age, from 2010 to 2019, HD death rates decreased by 5.5% among adults aged 35 to 54 years and by 2.3% among adults aged 55 to 74 years. In 2020, the rates increased by 12.0% for the younger cohort and by 7.8% for the older cohort. For both the younger (54.1 vs 51.1 per 100,000) and older (297.3 vs 282.5 per 100,000) cohorts the 2020 HD death rates were higher than the 2010 rates.

Additional study is needed to evaluate whether the increased rates in HD mortality were associated with the fact that SARS-CoV-2 infection can increase risk for new or worsening cardiovascular disease, or whether pandemic-related behavioral changes such as reduced physical activity or increased tobacco and alcohol use were significant contributors to these trends, it was suggested.

The study authors concluded, “National declines in HD death rates had reversed by 2020 during the Coronavirus Disease-2019 pandemic. Setbacks represented approximately 5 years of lost progress among all adults and ≥10 years of lost progress among non-Hispanic Black adults and younger adults. Clinical and public health efforts may need to be modified to reverse negative trends in HD mortality.”