Comprehensive study of England’s health data uncovers changing cardiovascular disease trends before and after COVID-19 

An analysis of electronic health records (EHRs) for 57 million people in England has revealed evolving trends in cardiovascular disease before, during, and after the COVID-19 pandemic. The findings highlight significant health inequalities and regional variations that could help target future prevention and care strategies. 

The national cohort study led by scientists from the Universities of Edinburgh, Cambridge, and University College London, with support from the BHF Data Science Centre at Health Data Research UK, examined 79 cardiovascular conditions using linked health data collected between January 2020 and May 2024. The study offers a detailed view of how the pandemic affected diagnosis, outcomes, and disparities across England. 

To build a detailed picture, the researchers analyzed data on several key measures: the rate of new diagnoses per 100,000 people, the percentage of people living with both existing and new diagnoses, the proportion of patients who died within 30 days of diagnosis, and the rate of heart attacks and strokes occurring between 30 days and one year after diagnosis. They compared these measures before and after the pandemic, considering factors such as age, sex, ethnicity, deprivation, geography, and the number of long-term conditions individuals were living with. 

According to the study, the number of new diagnoses of heart conditions fell sharply during the first national lockdown in 2020, while those who did receive diagnoses were more likely to die within 30 days compared with other periods. The researchers suggested that these declines reflected healthcare pressures and reduced access to services, as only the most severe cases sought medical attention. 

Disparities were evident across demographic and regional groups.  

“People of Bangladeshi, Indian, and Pakistani ethnicities were more likely to be diagnosed with coronary vascular disease, while people of African, Caribbean, and other Black ethnicities were more likely to experience conditions related to high blood pressure,” the authors reported. 

In addition, heart attack and stroke fatality rates were higher in the North, Midlands, and coastal areas of the East, as well as in more deprived regions. 

Although incidence rates for myocardial infarction and peripheral vascular disease decreased after the pandemic, prevalence increased for ischemic stroke by 16%, heart failure by 25%, and atrial fibrillation by 3%. Rates of post-diagnosis myocardial infarction, stroke, and heart failure occurring between 30 days and one year also rose. 

Co-author Professor William Whiteley, Associate Director at the BHF Data Science Centre, said the study showed that “during the COVID-19 pandemic there were drops in the incidence of some cardiovascular disease, and that disparities in the burden of these conditions were borne unequally by England’s diverse population.” He added that as diagnosis rates have since returned to pre-pandemic levels, the findings “could provide a foundation to push healthcare resources fairly to who and where they’re needed most.” 

Professor Angela Wood, University of Cambridge, added that the data “may reflect the direct effects of the COVID-19 virus, as well as the indirect effects of disruption to healthcare delivery and delayed care,” emphasizing that: 

“Harnessing whole population data in a responsible, trustworthy, and secure manner can help us to pinpoint health inequalities, track changes over time, and influence policy decision-making.” 

Principal author Dr Elias Allara emphasized that the analysis “paints England’s burden of cardiovascular disease in unprecedented detail,” adding that:  

“By revealing where the biggest gaps are in cardiovascular diagnosis and care, our findings lay the groundwork for action to tackle these important inequalities.” 

The team has also developed an interactive dashboard, available via the BHF Data Science Centre, to support policymakers, researchers, and the public in exploring these findings and informing future cardiovascular health strategies.