TY - JOUR
T1 - The impact of the COVID-19 pandemic on cardiovascular disease prevention and management
T2 - a population-scale analysis of trends in medication data
AU - CVD-COVID-UK Consortium
AU - Dale, Caroline E
AU - Takhar, Rohan
AU - Carragher, Ray
AU - Katsoulis, Michail
AU - Torabi, Fatemeh
AU - Duffield, Stephen
AU - Kent, Seamus
AU - Mueller, Tanja
AU - Kurdi, Amanj
AU - McTaggart, Stuart
AU - Abbasizanjani, Hoda
AU - Hollings, Sam
AU - Scourfield, Andrew
AU - Lyons, Ronan
AU - Griffiths, Rowena
AU - Lyons, Jane
AU - Davies, Gareth
AU - Harris, Dan
AU - Handy, Alex
AU - Mizani, Mehrdad Alizadeh
AU - Tomlinson, Chris
AU - Thygesen, Johan H
AU - Ashworth, Mark
AU - Denaxas, Spiros
AU - Banerjee, Amitava
AU - Sterne, Jonathan
AU - Brown, Paul
AU - Bullard, Ian
AU - Priedon, Rouven
AU - Mamas, Mamas A
AU - Slee, Ann
AU - Lorgelly, Paula
AU - Pirmohamed , Munir
AU - Khunti, Kamlesh
AU - Morris, Andrew
AU - Sudlow, Cathie
AU - Akbari, Ashley
AU - Bennie, Marion
AU - Sattar, Naveed A.
AU - Sofat, Reecha
PY - 2023/1/19
Y1 - 2023/1/19
N2 - Cardiovascular disease (CVD) remains the most common cause of mortality and morbidity worldwide, yet the impact of the COVID-19 pandemic on CVD and its risk factors remains unstudied. We use medication data to proxy CVD management using routinely collected anonymised individual-level data comprising 1.32 billion records of linked community dispensed CVD medications from England, Scotland and Wales between April 2018 and July 2021. We describe monthly prevalent and incident counts, annual monthly percentage change of medicines dispensed by CVD indications, focusing on hypertension, hypercholesterolaemia, diabetes, and use interrupted time-series analysis to model the impact of the pandemic. A decline in medicines used for CVD prevention was observed with 733,586 (95%CI 516,763 to 950,409) fewer individuals initiating antihypertensive treatment than expected. This could result in 20,399 additional CVD events, including 3,406 myocardial infarctions (MIs) and 5,188 strokes, should individuals remain untreated over their lifecourse. Incident use of lipid-lowering medicines decreased by 41,456 (95%CI 31,106 to 51,805) patients per month compared to the predicted pre-pandemic trend. Use of incident medicines to treat type-2 diabetes (T2DM) decreased by approximately 12,287 (95%CI 7,686 to 16,887) patients per month. Methods to identify and treat individuals who have missed treatment and remain undiagnosed are urgently required to avoid large numbers of additional future CVD events, further adding to the indirect impacts of the COVID-19 pandemic.
AB - Cardiovascular disease (CVD) remains the most common cause of mortality and morbidity worldwide, yet the impact of the COVID-19 pandemic on CVD and its risk factors remains unstudied. We use medication data to proxy CVD management using routinely collected anonymised individual-level data comprising 1.32 billion records of linked community dispensed CVD medications from England, Scotland and Wales between April 2018 and July 2021. We describe monthly prevalent and incident counts, annual monthly percentage change of medicines dispensed by CVD indications, focusing on hypertension, hypercholesterolaemia, diabetes, and use interrupted time-series analysis to model the impact of the pandemic. A decline in medicines used for CVD prevention was observed with 733,586 (95%CI 516,763 to 950,409) fewer individuals initiating antihypertensive treatment than expected. This could result in 20,399 additional CVD events, including 3,406 myocardial infarctions (MIs) and 5,188 strokes, should individuals remain untreated over their lifecourse. Incident use of lipid-lowering medicines decreased by 41,456 (95%CI 31,106 to 51,805) patients per month compared to the predicted pre-pandemic trend. Use of incident medicines to treat type-2 diabetes (T2DM) decreased by approximately 12,287 (95%CI 7,686 to 16,887) patients per month. Methods to identify and treat individuals who have missed treatment and remain undiagnosed are urgently required to avoid large numbers of additional future CVD events, further adding to the indirect impacts of the COVID-19 pandemic.
KW - Covid-19
KW - cardiovascular disease
KW - disease prevention and management
U2 - 10.1038/s41591-022-02158-7
DO - 10.1038/s41591-022-02158-7
M3 - Article
VL - 29
SP - 219
EP - 225
JO - Nature Medicine
JF - Nature Medicine
SN - 1078-8956
ER -
