The impact of the COVID-19 pandemic on cardiovascular disease prevention and management.

Mamas, M; Scourfield, A; Dale, CE; Takhar, R; Carragher, R; Katsoulis, M; Torabi, F; Duffield, S; Kent, S; Mueller, T; Kurdi, A; Le Anh, TN; McTaggart, S; Abbasizanjani, H; Hollings, S; Ashworth, M; Denaxas, S; Banerjee, A; Sterne, JAC; Brown, P; Bullard, I; Priedon, R; Slee, A; Lorgelly, P; Pirmohamed, M; Khunti, K; Morris, AD; Sudlow, C; Akbari, A; Bennie, M; Sattar, N; Sofat, R; Consortium, CVD-COVID-UK; Lyons, RA; Griffiths, R; Lyons, J; Davies, G; Harris, D; Handy, A; Mizani, MA; Tomlinson, C; Thygesen, JH

doi:10.1038/s41591-022-02158-7

The impact of the COVID-19 pandemic on cardiovascular disease prevention and management.

Mamas, M; Scourfield, A; Dale, CE; Takhar, R; Carragher, R; Katsoulis, M; Torabi, F; Duffield, S; Kent, S; Mueller, T; Kurdi, A; Le Anh, TN; McTaggart, S; Abbasizanjani, H; Hollings, S; Ashworth, M; Denaxas, S; Banerjee, A; Sterne, JAC; Brown, P; Bullard, I; Priedon, R; Slee, A; Lorgelly, P; Pirmohamed, M; Khunti, K; Morris, AD; Sudlow, C; Akbari, A; Bennie, M; Sattar, N; Sofat, R; Consortium, CVD-COVID-UK; Lyons, RA; Griffiths, R; Lyons, J; Davies, G; Harris, D; Handy, A; Mizani, MA; Tomlinson, C; Thygesen, JH

Authors

Mamas Mamas m.mamas@keele.ac.uk

A Scourfield

CE Dale

R Takhar

R Carragher

M Katsoulis

F Torabi

S Duffield

S Kent

T Mueller

A Kurdi

TN Le Anh

S McTaggart

H Abbasizanjani

S Hollings

M Ashworth

S Denaxas

A Banerjee

JAC Sterne

P Brown

I Bullard

R Priedon

A Slee

P Lorgelly

M Pirmohamed

K Khunti

AD Morris

C Sudlow

A Akbari

M Bennie

N Sattar

R Sofat

CVD-COVID-UK Consortium

RA Lyons

R Griffiths

J Lyons

G Davies

D Harris

A Handy

MA Mizani

C Tomlinson

JH Thygesen

Abstract

How the Coronavirus Disease 2019 (COVID-19) pandemic has affected prevention and management of cardiovascular disease (CVD) is not fully understood. In this study, we used medication data as a proxy for CVD management using routinely collected, de-identified, individual-level data comprising 1.32 billion records of community-dispensed CVD medications from England, Scotland and Wales between April 2018 and July 2021. Here we describe monthly counts of prevalent and incident medications dispensed, as well as percentage changes compared to the previous year, for several CVD-related indications, focusing on hypertension, hypercholesterolemia and diabetes. We observed a decline in the dispensing of antihypertensive medications between March 2020 and July 2021, with 491,306 fewer individuals initiating treatment than expected. This decline was predicted to result in 13,662 additional CVD events, including 2,281 cases of myocardial infarction and 3,474 cases of stroke, should individuals remain untreated over their lifecourse. Incident use of lipid-lowering medications decreased by 16,744 patients per month during the first half of 2021 as compared to 2019. By contrast, incident use of medications to treat type 2 diabetes mellitus, other than insulin, increased by approximately 623 patients per month for the same time period. In light of these results, methods to identify and treat individuals who have missed treatment for CVD risk factors and remain undiagnosed are urgently required to avoid large numbers of excess future CVD events, an indirect impact of the COVID-19 pandemic.

Citation

Mamas, M., Scourfield, A., Dale, C., Takhar, R., Carragher, R., Katsoulis, M., …Thygesen, J. (2023). The impact of the COVID-19 pandemic on cardiovascular disease prevention and management. Nature Medicine, 219 - 225. https://doi.org/10.1038/s41591-022-02158-7

Journal Article Type	Article
Acceptance Date	Nov 28, 2022
Publication Date	Jan 19, 2023
Journal	Nature Medicine
Print ISSN	1078-8956
Publisher	Nature Publishing Group
Pages	219 - 225
DOI	https://doi.org/10.1038/s41591-022-02158-7
Public URL	https://keele-repository.worktribe.com/output/426555
Publisher URL	https://www.nature.com/articles/s41591-022-02158-7