Cardiovascular diseases include coronary heart disease, stroke, heart failure and high blood pressure. Coronary artery disease includes clogged arteries or atherosclerosis of the heart, and thus can lead to a heart attack.
In 2020, the number of deaths from cardiovascular causes is higher than cardiovascular deaths in any year since 2003. In the United States, the largest increases in deaths are observed among Asian, Black and Hispanic minorities. A dramatic return of experience which nevertheless opens up major opportunities to solve the structural and societal problems which can explain these disparities in terms of health, note these experts.
Cardiovascular diseases still the leading cause of death
The number of deaths from cardiovascular disease (CVD) in the United States has increased from 874,613 in 2019 to 928,741 in 2020. Thus, CVD mortality exceeds the previous peak of 910,000 deaths, recorded in 2003. These new data recall and confirm cardiovascular disease as the leading cause of death worldwide, killing more than 19 million people worldwide of all ages, genders and nationalities each year.
The weight of the various cardiovascular diagnoses:
- globally, ischemic heart disease (or coronary heart disease) and cerebrovascular accident (CVA) represent the 2 main causes of cardiovascular death and represent respectively 16.2% and 11.6% of all causes of death;
- These rates have increased worldwide over the past decade in all regions except North America and Europe/Central Asia;
- in 1990, coronary heart disease accounted for 28.2% of all deaths and 18.7% of all deaths in 2019 in North America;
- strokes have increased from 7.3% of all deaths in 1990 to 6.4% of all deaths in 2019, in North America;
- in Europe and Central Asia, coronary heart disease fell from 27.2% of all causes of death in 1990 to 24.4% in 2019, stroke fell from 15.1% of all causes of death in 1990 to 12.5% in 2019.
- Of note, sub-Saharan Africa has the lowest proportion of deaths from cardiovascular disease as a percentage of all causes of death.
- Not only has the total number of cardiovascular disease-related deaths increased from 2019 to 2020,
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but the age-adjusted death rate increased for the first time in many years and by 4.6% in 2020,
explains one of the main authors of this report, Dr. Connie W. Tsao, professor of medicine at Harvard Medical School and cardiologist at Beth Israel Deaconess Medical Center (Boston): “Until then, even though the total number of deaths had slowly increased over the last decade, we were seeing a decline each year in our age-adjusted rates. In 2020, the COVID-19 pandemic turned the tide, especially before vaccines became available to slow its spread.”
Ethnic minorities are more strongly affected by the increase in deaths from cardiovascular causes. The analysis finds that people from these communities were among the most affected and had a disproportionate burden of cardiovascular risk factors such as hypertension and obesity. Socio-economic factors, as well as less access to health care, have not allowed equitable care for all.
“We know that COVID-19 has wreaked tremendous havoc and this preliminary data from the US Centers for Disease Control and Prevention (CDC) shows a substantial increase in all-cause mortality since the start of the pandemic. COVID-19 has both direct and indirect impacts on cardiovascular health. The virus is associated with bleeding disorders and inflammation. We also know that many people with new or pre-existing symptoms of heart disease and stroke were slow to seek care, especially early in the pandemic.
These factors have resulted in more patients with more advanced stages of cardiovascular disease and therefore more deaths.”