The American Heart Association (AHA), in collaboration with the US National Institutes of Health (NIH) and other federal agencies, publishes a statistical update detailing the latest statistics on cardiovascular disease and its contributing factors in the United States. In its 2023 report, the American Heart Association discusses some of the ways that Coronavirus disease 2019 (COVID-19) has affected cardiovascular health, particularly among Black, Hispanic, and Asian Americans, many of whom were already at increased risk of adverse health outcomes.
Stady: Heart disease and stroke statistics – 2023 update: A report from the American Heart Association. Image credit: Yurchanka Siarhhei / Shutterstock.com
An update on cardiovascular risk factors
The AHA’s Life’s Essential 8 distinguishes health behaviors, such as smoking, physical activity, diet, and weight, as well as personal factors such as cholesterol levels, blood pressure, and glucose control, that contribute to cardiovascular health.
In its 2023 report, the American Heart Association states that despite a steady decline in cigarette use over the past several years, many marginalized populations across the United States continue to use tobacco at much higher rates than the general population. More than 27% of American Indian/Alaska Native adults and youth, as well as more than 16% of lesbian, gay, and bisexual adults reported using cigarettes compared to 13% of whites and 12.3% of heterosexual/straight adults, respectively. Moreover, e-cigarette use has also increased in the United States, especially among middle and high school students at rates of 2.8% and 11.3%, respectively.
21% of children ages 6-17 reported having more than 60 minutes of daily physical activity between 2019 and 2020. This was compared to about 54% of adults in 2018 who self-reported meeting recommended aerobic guidelines .
Between 2017 and March 2020, approximately 37% of children and adolescents between the ages of 2 and 19 were obese or overweight. Importantly, the highest rates of obesity in these patients were reported among Hispanic males and Black females.
The impact of COVID-19
By July 2022, more than 1,000,000 deaths from COVID-19 had been reported in the United States, which equates to more than 300 deaths per 100,000 people. This fatality rate has been estimated at 292 deaths per 100,000 people in urban areas compared to those in non-urban areas, where COVID-19 causes 392 deaths per 100,000 people.
Although life expectancy in the United States has decreased for the general population, these societies have experienced greater declines in life expectancy rates. For example, life expectancy among black individuals decreased from 74.7 to 71.8 years, while Hispanic individuals experienced a decrease in life expectancy from 81.8 years to 78.8 years. In comparison, life expectancy for white individuals decreased by 1.2 years, from 78.8 to 77.6 years.
In addition to their observations on cardiovascular risk factors alone, the AHA report also discussed the impact of the COVID-19 pandemic on these risk factors. For example, physical activity decreased dramatically during the COVID-19 pandemic, as sedentary individuals were at greater risk of hospitalization or death from COVID-19.
In an effort to reduce the spread of SARS-CoV-2, particularly among high-risk patient groups, many patients have chosen to stay home rather than attend regular healthcare visits. In fact, the current AHA report notes that weekly cholesterol testing rates fell by more than 39% in 2020, with the largest decline observed between March and May 2020.
This reluctance and/or inability to seek medical care has increased the demand for both acute and urgent healthcare treatments of what would otherwise be dealt with in chronic conditions. In fact, missing out on these essential physician visits could potentially lead to unnecessary deaths in patients, especially those living with certain comorbidities.
Between 2019 and 2020, deaths related to cardiovascular disease rose from more than 870,000 to more than 928,000, the largest single-year increase since 2015. The current AHA report finds that COVID-19 has had a significant impact on people of all ages and ethnicities in the United States; However, the Hispanic, Asian, and Black communities were often affected the most.
The burden of cardiovascular risk factors, such as hypertension and obesity, is similarly high among this population. As a result, the Asian, Black, and Hispanic communities also experienced the largest increases in deaths related to cardiovascular disease, reducing these individuals’ life expectancies and increasing the disparity between them and the white communities.
Since many risk factors for cardiovascular disease are also associated with an increased risk of death from COVID-19, it is not surprising that those living in poverty, as well as Hispanic individuals, are particularly vulnerable to the effects of COVID-19.
We know that to address the discrimination and disparities that affect health, we must recognize and better understand the unique experiences of individuals and populations.”
- Tsao, CW, Aday, AW, Al Marzouq, ZI, et al. (2023). Heart disease and stroke statistics – 2023 update: A report from the American Heart Association. American Heart Association. doi: 10.1161/CIR.0000000000001123.