According to the American Heart Association's Heart Disease and Stroke Statistics — 2023 Update, the number of deaths from cardiovascular disease in the United States increased from 874,613 in 2019 to 928,741 in 2020.
The most extensive increase in CVD fatalities in the United States in years, among Asian, Black, and Hispanic populations, according to the American Heart Association's 2023 Statistical Update.
- More people died from cardiovascular-related causes in 2020, the first year of the COVID-19 pandemic, than in any year since 2003, according to data reported in the American Heart Association’s 2023 Statistical Update.
- The largest increases in deaths were seen among Asian, Black, and Hispanic people.
- While the pandemic’s effects on death rates may be noticed for several years, lessons learned offer major opportunities to address structural and societal issues that drive health disparities, according to Association leaders.
The number of CVD fatalities in the United States increased from 874,613 in 2019 to 928,741 in 2020, according to the most recent available data from the American Heart Association, a global movement for better lives for everyone. Circulation, the Association's flagship peer-reviewed journal, is published today.
"What's even more surprising is that our age-adjusted mortality rate has increased for the first time in decades," said Connie W. Tsao, an assistant professor of medicine at Harvard Medical School and an attending staff cardiologist at Beth Israel Deaconess Medical Center in Boston."
Asian, Black, and Hispanic individuals experienced the greatest increase in CVD-related deaths, as well as populations most impacted in the early days of the epidemic, which heightened structural and social inequality.
Michelle A. Albert, M.D., FAHA, the American Heart Association's volunteer president for the University of California at San Francisco (UCSF) and the Admissions Dean for UCSF Medical School, claims that COVID-19 caused significant cardiovascular damage.
Albert, who is also the director of the UCSF College of Social Sciences' Northurture Center, and is a well-known authority on health equity and adversity research, believes that the greater numbers of coronary heart disease deaths among Asian, Black, and Hispanic adults are related to the persons most frequently infected with COVID-19.
Albert said people from minority backgrounds were among the most likely to be negatively impacted, especially early on, due to a disproportionate number of cardiovascular risk factors, such as hypertension and obesity. The American Heart Association has launched the first-ever rapid response research grants, urging the scientific community to turn around transformative research, and to promote equitable health for all.
Coronary heart disease, also known as 'heart disease,' continues to rank fifth among all causes of death behind heart disease, cancer, COVID-19, and unintentional injuries/accidents.
Most sections of the text are encased in data points and scientific research findings, all of which are relevant to this year's statistical update. This year, many references to COVID-19 and its effect on cardiovascular disease are included.
According to members of the Statistical Update's writing committee, age, gender, and ethnic groups have no differences in their scores. However, data from other underrepresented populations, such as LGBTQ people and persons living in rural vs. urban areas in the United States, remains incomplete.
"To combat health discrimination and disparities, we must better recognize and understand individuals and populations," Tsao said. "But the data is fragmentary because these groups are grossly underrepresented in clinical and epidemiological research. It will be vital to the American Heart Association's objective to achieve cardiovascular health equity for all in the United States and globally."
Data on the globe
Cardiovascular disease remains the number one killer in the world, killing more than 19 million people every year, including people of all ages, genders, and nationalities. Yet, certain populations in the United States as well as around the world are still at risk of heart disease and stroke.
Supplemental tables in this year's statistical update examine the global pattern of CVD-related deaths worldwide and regionally, as well as the number and proportion of deaths caused by various cardiovascular diagnoses in various countries and regions.
- Globally, ischemic heart disease and stroke represent the top two causes of CVD-related deaths and account for 16.2% and 11.6% of all causes of deaths, respectively. These rates have increased across the world over the past decade in all but two regions – North America and Europe/Central Asia. Note that ischemic heart disease is the term used in global data sources and is also known as coronary heart disease.
- In 1990, ischemic heart disease represented 28.2% of all deaths in North America, dropping to 18.7% of all deaths in 2019. Stroke dropped from 7.3% of all deaths in North America in 1990 to 6.4% of all deaths in 2019.
- In the region of Europe and Central Asia, ischemic heart disease dropped from 27.2% of all causes of death in 1990 to 24.4% in 2019, while stroke represented 15.1% of all causes of death in 1990 and dropped to 12.5% in 2019.
- The region of East Asia and Pacific is the only region where stroke represents the highest proportion of CVD-related deaths, with the proportion of deaths increasing from 14.8% in 1990 to 18.3% in 2019. During this same time period, the proportion of deaths caused by ischemic heart disease nearly doubled from 8.1% to 15.6%.
- The region of Sub-Saharan Africa noted the lowest proportion of CVD-related deaths as a percentage of all causes of death. Stroke was the leading cause of CVD-related deaths in the region of Sub-Saharan Africa in 1990, representing 3.6% of all causes, followed by ischemic heart disease (3.1%). In 2019, ischemic heart disease and stroke were both at 5.4% of total deaths.
"It's critical that we recognize and redouble our efforts in nearly a century of research, advocacy, and education, while identifying and removing barriers that still put certain individuals at disproportionately higher risk of cardiovascular disease," Albert said. "This definitive statistical update is one of the reasons the American Heart Association publishes this definitive statistical update annually, providing a comprehensive resource of the most current data, relevant scientific findings, and assessment of the impact of cardiovascular disease nationally and internationally."
Reference: "Heart disease and stroke statistics: A report from the American Heart Association" 25 January 2023, Circulation. DOI: 10.1161/CIR.0000000000001123
Tsao stressed that this surveillance is a must-have resource for lay people, policymakers, media professionals, health administrators, health advocates, and others looking for the most current information on these issues and conditions.
A volunteer writing group for the American Heart Association Council on Epidemiology and Prevention Statistics Committee and the Stroke Statistics Subcommittee prepared this statistical update.