Qamar Afifa, Abramov Dmitry, Bang Vijay, Chew Nicholas Ws, Kobo Ofer, Mamas Mamas A
Lancashire Teaching Hospitals, Preston, England, United Kingdom.
Division of Cardiology, Department of Medicine, Loma Linda Health, Loma Linda, CA, USA.
Int J Cardiol Cardiovasc Risk Prev. 2024 Mar 14;21:200248. doi: 10.1016/j.ijcrp.2024.200248. eCollection 2024 Jun.
During the covid-19 pandemic there was a marked rise in the number of cardiovascular deaths. Obesity is a well-known modifiable risk factor for cardiovascular disease and has been identified as a factor which leads to poorer covid-19 related outcomes. In this study we aimed to analyse the impact of covid-19 on obesity-related cardiovascular deaths compared to trends seen 20 years prior. We also analysed the influence different demographics had on mortality.
Multiple Cause of Mortality database was accessed through CDC WONDER to obtain the obesity-related and general cardiovascular crude mortality and age adjusted mortality rates (AMMR) between 1999 and 2020 in the US. The obesity-related sample was stratified by demographics and cardiovascular mortality was subdivided into ischemic heart disease, heart failure, hypertension and cerebrovascular disease. Joinpoint Regression Program (Version 4.9.1.0) was used to calculate the average annual percent change (AAPC) in AAMR, and hence projected AAMR. Excess mortality was calculated by comparing actual AAMR in 2020 to projected values.
There were an estimated 3058 excess deaths during the early stages of the pandemic impacting all cohorts. The greatest excess mortalities were seen in men, rural populations and in Asian/Pacific Islander and Native Americans. Interestingly the greatest overall mortality was seen in the Black American population. Our study highlights important, both pre and during the pandemic, in obesity related cardiovascular disease mortality which has important implications for ongoing public health measures.
在新冠疫情期间，心血管疾病死亡人数显著上升。肥胖是心血管疾病一个众所周知的可改变风险因素，并且已被确定为导致新冠相关不良后果的一个因素。在本研究中，我们旨在分析新冠疫情对肥胖相关心血管疾病死亡的影响，并与20年前的趋势进行比较。我们还分析了不同人口统计学特征对死亡率的影响。
通过疾病控制与预防中心（CDC）的WONDER数据库获取1999年至2020年美国肥胖相关和一般心血管疾病的粗死亡率及年龄调整死亡率（AMMR）。肥胖相关样本按人口统计学特征分层，心血管疾病死亡率细分为缺血性心脏病、心力衰竭、高血压和脑血管疾病。使用Joinpoint回归程序（版本4.9.1.0）计算年龄调整死亡率的年均变化百分比（AAPC），从而预测年龄调整死亡率。通过将2020年的实际年龄调整死亡率与预测值进行比较来计算超额死亡率。
在疫情早期估计有3058例超额死亡，影响所有队列。男性、农村人口以及亚裔/太平洋岛民和美洲原住民的超额死亡率最高。有趣的是，美国黑人人口的总体死亡率最高。我们的研究强调了在疫情之前和期间肥胖相关心血管疾病死亡率方面的重要性，这对正在实施的公共卫生措施具有重要意义。
