4.6 Article

Impact of the COVID-19 Pandemic on Diabetes-Related Cardiovascular Mortality in the United States

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WILEY
DOI: 10.1161/JAHA.122.028896

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cardiovascular mortality; COVID-19; diabetes; ischemic heart disease; racial disparities

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In the past few decades, diabetes-related cardiovascular mortality has been declining, but the COVID-19 pandemic caused a significant increase in mortality in the first year. Younger patients and the Black population experienced the greatest increase in mortality.
BackgroundIn the past few decades, diabetes-related cardiovascular mortality has been steadily declining. However, the impact of the COVID19 pandemic on this trend has not been previously defined. Methods and ResultsDiabetes-related cardiovascular mortality data were extracted for each year between 1999 and 2020 from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. Regression analysis was used to calculate the trend in the 2 decades before the pandemic (1999-2019) and thereby estimate the excess cardiovascular mortality in 2020. There was a 29.2% fall in the diabetes-related cardiovascular age-adjusted mortality rate between 1999 to 2019, largely driven by a 41% decrease in ischemic heart disease deaths. In comparison to 2019, there was an overall 15.5% increase in the diabetes-related cardiovascular age-adjusted mortality rate in the first year of the pandemic, mainly due to a 14.1% rise in ischemic heart disease deaths. Younger patients (under 55 years) and the Black population experienced the greatest increase in diabetes-related cardiovascular age-adjusted mortality rate (24.0% and 25.3%, respectively). Trend analysis estimated 16 009 excess diabetes-related cardiovascular deaths in 2020, with the majority due to ischemic heart disease (8504). Black and Hispanic or Latino populations had at least one-fifth of their 2020 diabetes-related cardiovascular age-adjusted mortality rate as excess deaths (22.3% and 20.2%, respectively). ConclusionsThere was a sharp rise in diabetes-related cardiovascular mortality during the first pandemic year. Black, Hispanic or Latino, and young people showed the largest increases in diabetes-related cardiovascular mortality. Targeted health policies could help address the disparities observed in this analysis.

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