While cardiovascular disease mortality declined overall from 1999 to 2023, rates increased during the COVID-19 pandemic and recovery across different categories of disease has been uneven, according to a JACC Data Report published June 23.

Using data from the U.S. Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER) database, Brandon W. Yan, MD, MPH, et al., looked at cases where cardiovascular disease was either the underlying cause or contributing cause to the death. They calculated age-adjusted mortality rates (AAMRs) per 100,000 people to visualize temporal trends in cardiovascular disease mortality from 1999 to 2023.

Although the AAMR for underlying cardiovascular disease mortality decreased by 33.5% overall – from 350.8 deaths per 100,000 in 1999 to 218.3 deaths per 100,000 in 2023 – mortality rates jumped up to 233.3 in 2021 during the pandemic.

In those with ischemic heart diseases or cerebrovascular diseases, mortality declined over the course of the study period. However, among those with hypertensive diseases, mortality rates doubled from 15.8 in 1999 to 31.9 in 2023. The authors note that this subtype of cardiovascular disease is "becoming the fastest rising underlying cause of cardiovascular death and, since 2022, the leading contributing cardiovascular cause of death."

Heart failure was another subtype where a significant increase in mortality rates was found. Originally declining from 20.3 in 1999 to 16.9 in 2011, rates spiked to 21.6 in 2023. Yan and colleagues note that this rate is the highest recorded.

Overall, they describe recovery from the effects of the COVID-19 pandemic as "uneven across disease categories," stating that "although the immediate pandemic-related impact may have subsided, underlying trends that existed before the pandemic continue to exert influence."