Abstract
Introduction: Heart disease (HD) death rates have been declining for decades. Updated trend data for 2010–2020 are needed to inform clinical and public health practice. Methods: We obtained age-standardized death rates per 100,000 population from the US Centers for Disease Control and Prevention’s WONDER database, which aggregates death certificate data from the National Vital Statistics System. Among adults aged ≥35 years, HD deaths were defined by underlying cause of death International Classification of Diseases, 10th revision codes. We calculated percent change between 2010, 2019, and 2020 death rates overall and by HD subtypes and demographic subgroups. Results: HD death rates declined during 2010-2019 and increased in 2020 across age, sex, and race and ethnicity groups. The national HD death rate declined by 9.8% from 2010 to 2019 (347.3 vs. 313.0 per 100,000) and increased by 4.1% in 2020 to 325.9 per 100,000, which approximated the 2015 rate (326.5 per 100,000). Coronary heart disease accounted for 55% of total HD deaths in 2020. Among non-Hispanic Black adults, the HD death rate declined by 10.4% during from 2010 to 2019 and increased by 11.2% in 2020, returning the 2020 HD death rate (440.7 per 100,000) to approximately the 2010 rate (442.4 per 100,000). Among adults aged 35–54 and 55–74 years, HD death rates declined from 2010 to 2019 (35–54: 5.5%, 55–74: 2.3% decline) and increased in 2020 (35–54: 12.0%, 55–74: 7.8% increase), resulting in a higher HD death rate in 2020 (35–54: 54.1, 55–74: 297.3 per 100,000) than in 2010 (35–54: 51.1, 55–74: 282.5 per 100,000). Conclusions: National declines in HD death rates had reversed by 2020 during the Coronavirus Disease-2019 pandemic. Setbacks represented approximately 5 years of lost progress among all adults and ≥10 years of lost progress among non-Hispanic Black adults and younger adults. Clinical and public health efforts may need to be modified to reverse negative trends in HD mortality.
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