Jan. 27, 2023 – Cardiovascular-related deaths increased dramatically in 2020, marking the largest single-year increase since 2015 and surpassing the previous record from 2003, according to the 2023 Statistical Update from the American Heart Association.

During the first year of the COVID-19 pandemic, the largest increases in cardiovascular disease (CVD) deaths were seen among Asian, Black, and Hispanic people.

"We thought we had been improving as a country with respect to CVD deaths over the past few decades," says Connie Tsao, MD, chair of the Heart Association's Statistical Update writing committee. 

But since 2020, those trends have changed. Tsao, a staff cardiologist at Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School, noted the firsthand experience that many health care professionals had in seeing the shift.

"We observed this sharp rise in age-adjusted CVD deaths, which corresponds to the COVID-19 pandemic," she says. "Those of us health care providers knew from the overfull hospitals and ICUs that clearly, COVID took a toll, particularly in those with cardiovascular risk factors."

Each year, the American Heart Association and National Institutes of Health report the latest statistics related to heart disease, stroke, and cardiovascular risk factors. The 2023 update includes more information about pandemic-related data.

Overall, the number of people who died from cardiovascular disease increased during the first year of the pandemic, rising from 876,613 in 2019 to 928,741 in 2020. This topped the previous high of 910,000 in 2003.

The age-adjusted mortality rate also increased for the first time in several years, Tsao says, by a "fairly substantial" 4.6%. The age-adjusted mortality rate takes note of the changes in the aging population from year to year, accounting for higher death rates among older people.

"Even though our total number of deaths have been slowly increasing over the past decade, we have seen a decline each year in our age-adjusted rates – until 2020," she says. "I think that is very indicative of what has been going on within our country – and the world – in light of people of all ages being impacted by the COVID-19 pandemic, especially before vaccines were available to slow the spread."

The largest increases in CVD-related deaths were among Asian, Black, and Hispanic people, who were most heavily affected during the first year of the pandemic. 

"People from communities of color were among those most highly impacted, especially early on, often due to a disproportionate burden of cardiovascular risk factors, such as hypertension and obesity," Michelle Albert, MD, the Heart Association's president and a professor of medicine at the University of California at San Francisco, said in a statement.

Albert, who is also the director of UCSF's Center for the Study of Adversity and Cardiovascular Disease, does research in the area of health equity and noted the disparities seen in the 2020 numbers.

"Additionally, there are socioeconomic considerations, as well as the ongoing impact of structural racism on multiple factors, including limiting the ability to access quality health care," she said.

In a special commentary, the Statistical Update writing committee pointed to the need to track data for other underrepresented communities, including LGBTQ people and those living in rural or urban areas. The authors outlined several ways to better understand how identity and social issues affect health, as well as ways to reduce heart-related disparities.

"This year's writing group made a concerted effort to gather information on specific social factors related to health risk and outcomes, including sexual orientation, gender identity, urbanization, and socioeconomic position," Tsao says. "However, the data are lacking because these communities are grossly underrepresented in clinical and epidemiological research."

For the next several years, the Heart Association's Statistical Update will likely include more insights about the effects of the COVID-19 pandemic, as well as ongoing disparities.

"For sure, we will be continuing to see the effects of the pandemic for years to come," Tsao says. "Recognition of the disparities in outcomes among vulnerable groups should be a call to action among health care providers and researchers, administration, and policy leaders to investigate the reasons and make changes to reverse these trends."

Show Sources


Circulation: “Heart Disease and Stroke Statistics – 2023 Update: A Report From the American Heart Association.”

Connie Tsao, MD, staff cardiologist, Beth Israel Deaconess Medical Center; assistant professor of medicine, Harvard Medical School; chair, American Heart Association Statistical Update writing committee. 

American Heart Association: “COVID toll realized: CVD deaths take big jump, especially among certain populations,” “In Pursuit of Cardiovascular Health for All: Health Equity and the Heart Disease and Stroke Statistics 2023 Update.”


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