Did COVID-19 pandemic affect deaths from cardiovascular diseases in Japan?

Abstract

Abstract Background According to the vital statistics report by the Ministry of Health, Labour and Welfare, the total number of deaths in Japan had decreased in 2020 (1,384,544) for the first time in 11 years, and underlying reasons include the decrease of approximately 16,000 deaths from respiratory diseases. The number of deaths subsequently increased in 2021 (1,439,809), and this increase was attributable in part to the outbreak of the Delta variant of the coronavirus disease 2019 (COVID-19). To the best of our knowledge, effects of the COVID-19 pandemic and the new normal of life with COVID-19 (e.g., avoiding crowds, wearing masks, and practicing hand hygiene) on the number of deaths from cardiovascular diseases, which have been the second leading cause of death in Japan, have not been studied thus far. Purpose To investigate the association between deaths from cardiovascular diseases and COVID-19 in Japan. Methods Data from the demographic survey conducted by the Ministry of Health, Labour and Welfare and analyzed, Japan was retrospectively analyzed. Results The number of deaths from cardiovascular diseases decreased in 2019 (207,714) and 2020 (205,596) when compared with those recorded in the previous year; however, the deaths started to increase again in 2021 (Fig 1.). Next, we analyzed deaths at ≥65 years of age. With reference to 2017, the rate of increase in the number of deaths in individuals aged ≥85 years was ≥10%, showing that the increased total number of deaths was due to the increase of deaths in those aged ≥85 years. Among causes of death, heart failure showed a particularly large increase. Deaths in other age groups showed almost no changes or decreases, except for deaths in individuals aged 70–74 years showing a ≥20% increase (Fig 2.). Thus, we looked into changes in the number of deaths in groups of individuals aged 65–69, 70–74, and 75–79 years. Deaths from acute myocardial infarction showed particularly large decreases in both ranges of 65–69 years and 75–79 years. As the number of deaths at 65–69 years of age tended to decrease, deaths from other heart diseases also decreased more or less. As the number of deaths at 75–79 years of age showed almost no changes, deaths from ischemic heart disease and heart failure increased slightly. In contrast to the data for the younger and older age groups, deaths at 70–74 years from almost all causes including acute myocardial infarction, heart failure, ischemic heart diseases, and arrhythmia increased in number. Conclusion The number of deaths from heart diseases decreased in 2020 compared to that in the prior year; however, the decrease was not fully explainable on the basis of the COVID-19 pandemic because deaths from heart diseases already tended to decrease in 2019. Furthermore, the number of deaths from heart diseases increased in people aged 70–74 years as well as those aged ≥85 years. The underlying reason is currently unknown; thus, continued monitoring is necessary.figure1figure2