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Cardiovascular disease continues to drive excess post-pandemic deaths, study finds

Cardiovascular diseases are one of the main driving factors in an ongoing increased level of excess deaths seen since the pandemic, particularly in middle-aged adults, an analysis of UK data has concluded.

Figures from the Office for Health Improvement and Disparities (OHID) showed that between June 2022 and June 2023, excess deaths for 50-to-64-year-olds were 15% higher than normal.

For this age group, deaths involving cardiovascular diseases such as heart disease and stroke were 33% higher than expected, the commentary in The Lancet Regional Health journal said.

A more detailed look showed deaths involving ischaemic heart diseases were 44% higher than expected, cerebrovascular diseases 40% higher and heart failure 39% higher.

Acute respiratory infections were also related to significant excess deaths in the 50-64 age group with a 43% excess as well as diabetes which showed 35% excess.

Across all ages, deaths in a private home were 22% higher than expected and deaths from cardiovascular causes in private homes were 27% higher than expected, the authors said.

Overall, excess deaths were 11% higher than expected for 25-49-year-olds and under 25s, and only 9% higher for over 65s, the team from the Department of Health and Social Care, the Office for National Statistics and Continuous Mortality Investigation found.

Excess deaths in the data are likely to relate to direct and indirect impacts of the pandemic, including worsening pressures on NHS urgent care services, the direct effects of Covid-19 infection, and disruption to chronic disease prevention, detection and management, the commentary said.

The detailed breakdown by age and cause built on previous reports from the Office for National Statistics, which found over 7% more excess deaths in 2022 compared with the five-year average.

This more granular data can help inform cardiovascular disease prevention and management efforts, the authors said.

The ongoing impact on younger age groups contrasts with the excess deaths seen in older adults in the acute phase of the pandemic, they noted.

Earlier this year, the British Heart Foundation (BHF) also published an analysis showing almost 100,000 more people had died in England with cardiovascular disease than would be expected in the three years since the pandemic began.

Dr Jonathan Pearson-Stuttard, head of LCP health analytics who collaborated on the commentary, said: ‘Our commentary provides a data-driven review of the analyses with more detailed insights than previously available to assess the drivers of persisting excess deaths since the Covid-19 pandemic.

‘From summer 2022-23, excess deaths were most prominent in relative terms in middle-aged and younger adults, with deaths from heart disease and deaths in private homes being most affected.

‘Granular insights such as these provide opportunities to mitigate what seems to be a continued and unequal impact on mortality, and likely corresponding impacts on morbidity, across the population.’

Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist, said: ‘These figures raise obvious concerns. Amongst a range of issues likely driving a persistent excess of deaths from cardiovascular disease includes the consistently extreme pressure on the NHS.

‘Long waits for heart care are dangerous – they put someone at increased risk of avoidable hospital admission, disability due to heart failure and premature death. Yet people are struggling to get potentially lifesaving heart treatment when they need it due to a lack of NHS staff and sufficient, appropriately kitted out space, despite cardiovascular disease affecting record numbers of people.

‘As more and more heart patients wait longer and longer, it has never been more urgent for Government to deliver heart disease prevention and cut long waiting lists for people who need lifesaving heart and stroke care including through transformative, innovative care – and for the UK to power scientific breakthroughs to unlock revolutionary new tests and treatments.’

A version of this article was originally published by our sister publication Pulse.