Heart disease, stroke deaths rose during COVID-19 pandemic: study

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There was a "notable several-fold increase" in risk-associated deaths from heart disease and stroke during the beginning of the COVID-19 pandemic, according to researchers. 

In a study published Wednesday in the journal JAMA Network Open, authors from Kaiser Permanente, the Permanente Medical Group, the University of California San Francisco (UCSF) and the Northwestern University Feinberg School of Medicine said that from 2019 to 2020 the estimated age-adjusted mortality rate increased by 15.9%, largely due to COVID-19 mortality,

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Rates of stroke and heart disease also increased by 4.3% and 6.4%, respectively.

There were also greater increases in risk-associated deaths from heart disease and stroke among members of racial and ethnic minority groups, including a concerning highest increase among non-Hispanic Black individuals.

In addition, they wrote that while the age-adjusted mortality rate from heart disease and stroke decreased between 2011 and 2019, the number of deaths due to the conditions increased in association with the rapid growth rate of the population aged 65 years and older.

To reach these conclusions, the authors used age-adjusted mortality rates for heart disease and stroke, age-specific numbers of deaths and population estimates from 2011 to 2020 from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database.

The U.S. Census was the source of self-reported race and ethnicity data.

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For risk-associated increases in heart disease and stroke mortality, there were prevalent racial and ethnic disparities.

"Risk-associated increases were highest in non-Hispanic Black individuals, followed by Hispanic individuals, non-Hispanic Asian or Pacific Islander individuals, and non-Hispanic White individuals, with a more than 5-fold higher percentage increase in non-Hispanic Black individuals compared with non-Hispanic White individuals for HD and a 2-fold higher percent increase for stroke," they wrote. 

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The pandemic-related conditions that led to these increases included periods of overcrowding of hospitals with patients who had COVID-19 that resulted in fewer hospitalizations for acute cardiovascular problems, fewer visits for medical care, poorer medication adherence and increased barriers to healthy lifestyle behaviors. 

A reported "major limitation" of the study is potential inaccuracy in coding cause of death.

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"Our findings, combined with the continuing emergence of new virus strains associated with high COVID-19 rates, suggest that increased emphasis on the maintenance of optimal risk factor levels specified in the American Heart Association’s Life’s Simple 7 guideline and vigilance toward equity in access to health care are warranted more than ever," the researchers concluded.