TY - JOUR
T1 - The impact of the COVID-19 pandemic on cardiovascular disease prevention and management
AU - Dale, Caroline E.
AU - Takhar, Rohan
AU - Carragher, Raymond
AU - Katsoulis, Michail
AU - Torabi, Fatemeh
AU - Duffield, Stephen
AU - Kent, Seamus
AU - Mueller, Tanja
AU - Kurdi, Amanj
AU - Le Anh, Thu Nguyen
AU - McTaggart, Stuart
AU - Abbasizanjani, Hoda
AU - Hollings, Sam
AU - Scourfield, Andrew
AU - Lyons, Ronan A.
AU - Griffiths, Rowena
AU - Lyons, Jane
AU - Davies, Gareth
AU - Harris, Daniel
AU - Handy, Alex
AU - Mizani, Mehrdad A.
AU - Tomlinson, Christopher
AU - Thygesen, Johan H.
AU - Ashworth, Mark
AU - Denaxas, Spiros
AU - Banerjee, Amitava
AU - Sterne, Jonathan A.C.
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 D.
AU - Sudlow, Cathie
AU - Akbari, Ashley
AU - Bennie, Marion
AU - Sattar, Naveed
AU - Sofat, Reecha
AU - CVD-COVID-UK Consortium
PY - 2023/1/19
Y1 - 2023/1/19
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85146535705&partnerID=8YFLogxK
U2 - 10.1038/s41591-022-02158-7
DO - 10.1038/s41591-022-02158-7
M3 - Article
C2 - 36658423
AN - SCOPUS:85146535705
SN - 1078-8956
VL - 29
SP - 219
EP - 225
JO - Nature Medicine
JF - Nature Medicine
IS - 1
ER -
