COVID-19 Pandemic Linked to Increase in Cardiovascular Deaths in the United States
During the first two years of the pandemic, from March 2020 to March 2022, there were approximately 90,000 more deaths in the United States attributed to cardiovascular disease than were expected for that span of time. This alarming statistic has raised concerns among experts about the impact of COVID-19 on heart health.
The majority of these deaths occurred in individuals 65 and older, who are already at a higher risk for cardiovascular complications. However, there has also been a dramatic increase in heart-related deaths among younger adults. A study found that the sharpest rise in deaths from heart attacks during that period occurred in 25- to 44-year-olds.
While some of these cardiovascular-related fatalities may have been a result of limited access to medical care during the height of the pandemic, physicians and researchers now believe that COVID-19 itself played a significant role. In addition to the acute phase complications of COVID-19, there appears to be an increased risk of heart attacks, strokes, and other cardiovascular problems up to a year after an infection. The exact connection between the virus and the cardiovascular system remains the subject of ongoing research.
Cardiologists’ leading theory for how COVID-19 damages the heart and causes cardiovascular events is through widespread inflammation. Infectious diseases, particularly severe COVID-19 infections, can lead to inflammation, which increases the risk of cardiovascular complications. Inflammation and blood clotting caused by the immune system’s response to infection or injury can result in the rupture of plaque in the arteries, leading to heart attacks or strokes. Individuals with pre-existing plaque in their arteries, such as smokers and those with high blood pressure and cholesterol, are at the greatest risk of experiencing a COVID-19-induced heart attack.
In some cases, the inflammation caused by COVID-19 can lead to clot formation even without pre-existing plaque. Sufficient inflammation in the blood vessels can irritate the cells and cause a clot to form spontaneously, resulting in a heart attack in individuals without pre-existing plaque.
The potential for cardiovascular complications does not disappear after recovering from COVID-19. A large study conducted in 2022 found that individuals who had a COVID-19 infection had a significantly higher risk of developing heart-related diseases in the year following recovery. The risks included a 1.5 times higher risk of stroke, nearly twice the risk of a heart attack, and a 1.6 to 2.4 times higher risk of developing different types of arrhythmias.
Some of these complications may be caused by the lingering effects of the infection, while others may be due to the onset of risk factors for heart disease associated with COVID-19, particularly hypertension. Research has shown that nearly 21 percent of individuals who were hospitalized for a COVID-19 infection and almost 11 percent of individuals with a milder infection developed high blood pressure in the following months.
The stress of the pandemic and biological factors may contribute to the development of hypertension in COVID-19 patients. However, further research is needed to understand how COVID-19 leads to hypertension.
Vaccination has been shown to reduce the risk of heart attacks or strokes following a COVID-19 infection by approximately 40 to 60 percent compared to unvaccinated individuals. Vaccinated individuals are less likely to develop severe COVID-19, which subsequently lowers the risk of heart-related complications. Additionally, vaccines may help protect the cardiovascular system by reducing the inflammatory effects of COVID-19.
Although a small risk of myocarditis has been associated with mRNA COVID-19 vaccines, the risk of developing myocarditis after a COVID-19 infection is much higher. Recent studies have shown that males aged 12 to 29 were four to eight times more likely to develop myocarditis following a COVID-19 infection compared to developing it within three weeks after receiving a vaccine. For males 30 and older, the risk of myocarditis was 28 times higher from COVID-19 than from the vaccine.
Experts emphasize that the risk to the heart from COVID-19 is much greater than the risk from vaccination-related myocarditis.
To manage the risk of cardiovascular complications, individuals who have recently had COVID-19 and are experiencing any cardiovascular symptoms, such as chest pain or shortness of breath, or those at an increased risk for heart disease should contact their healthcare providers. Regular check-ups and monitoring of blood pressure and cholesterol are particularly important for individuals who have had COVID-19.
Individuals without risk factors or symptoms can inform their doctors about their COVID-19 history during their next annual check-up. In the meantime, practicing heart-healthy behaviors, such as regular exercise and a balanced diet, is recommended to maintain cardiovascular health.