• Cardiovascular disease is the biggest cause of death in the world and a factor in COVID-19 mortality rates.
  • Progress on heart disease is slowing in the United States.
  • We need a system approach to build healthier communities that are less vulnerable to cardiovascular disease.

As nations confront the coronavirus pandemic, cardiovascular disease (CVD) looms as the number one killer worldwide and a key contributor to COVID-19 complications. And on World Heart Day, under the mantra Use Heart to Beat CVD and its subtext Use Heart to Fight COVID-19, the opportunity to unify has never been greater.

“In an interconnected world, it is time to recognize a simple truth: Solidarity is self-interest,” said Antonio Guterres, secretary-general of the United Nations.

Guterres opened the 75th UN General Assembly, held Sept. 22-26, where addressing COVID-19 and non-communicable diseases (NCDs), including cardiovascular disease, were high on the agenda.

Reality check

“An estimated 150 million people will lose their lives too early from a non-communicable disease over the next decade and, right now, NCDs are intensifying the impact of COVID-19,” said Dr. Bente Mikkelsen, director of noncommunicable diseases with the World Health Organization.

Despite a global goal set in 2018 to reduce premature deaths from NCDs by one-third by 2030, only a handful of countries are on track, according to the NCD Countdown 2030 report.

A sobering study in the Sept. 9 edition of the Journal of the American Heart Association (JAMA) indicates that uncontrolled hypertension is increasing among Americans, dealing a blow to more than a decade of progress in heart disease.

Likewise, after decades of decline in premature cardiac deaths, considered “one of the major public health accomplishments of the 20th century,” progress has slowed significantly since 2011. A study published over the summer in JAMA points to rising cardiac deaths among younger adults outside of a hospital and widening health disparities along socioeconomic lines.

“We must invest and focus public and private efforts to address the disparities in risk factors, access to care and other factors,” said AHA president, Dr. Mitchell S.V. Elkind, professor of neurology and epidemiology at Columbia University and attending neurologist at Columbia University Irving Medical Center.

Three calls to action

The World Health Organization — which leads health initiatives within the UN system — issued three calls to action at the UN General Assembly:

  • Promote equitable access to COVID-19 tools
  • Build momentum toward sustainable development goals
  • Prepare for the next pandemic together, now.

Organizations like the American Heart Association are rethinking ways to educate the public on CVD prevention.

With an alarming percentage of patients not calling 911 or delaying critical care for fear of contracting COVID-19, the American Heart Association and the American Stroke Association relaunched Don’t Die of Doubt, a national awareness campaign sponsored by Medtronic.

The core message of the campaign is, the hospital is the safest place to be in an emergency, even during the pandemic. Patients are implored to seek care immediately if they exhibit signs of a heart attack or stroke.

Bridging the deepening divides

COVID-19 mortality rates
COVID-19 has exacerbated existing health divides.
Image: American Heart Association

“Over 90 percent are non-white, many don’t speak English,” said Sasson, who is also vice president for Emergency Cardiovascular Care Science and Innovation at the American Heart Association

With ZIP codes more influential than genetic codes in determining health and longevity, it is vital to lead sustainable change in underserved urban, rural and indigenous communities. That is especially important today, with COVID-19 disproportionately impacting communities of color.

A September 16 report from APM Research Lab, shows COVID-19 mortality rates in the U.S. among people of color compared with whites.

As a long-time champion of health equity, the American Heart Association is stepping up investments in community-led solutions to socioeconomic barriers to health through the AHA Social Impact Fund and the Bernard J. Tyson Impact Fund. Both funds have infused millions of dollars in organizations addressing issues ranging from food insecurity to mental health services and more.

The AHA also joined a national coalition of physician organizations and heart health experts teaming with ESSENCE magazine to address the staggering 40% higher rate of hypertension in Black women. Called “Release the Pressure,” the year-long campaign provides Black women with resources to know and track their blood pressure and develop a wellness plan.

On the research front, our organization funds studies that actively recruit diverse participants to fulfill the promise of personalized medicine.

Engaging lawmakers

Ultimately, sustainable change starts at the highest levels of society. That is why the American Heart Association supported provisions in the Families First Coronavirus Response Act and the Coronavirus Aid, Relief and Economic Security Act. Our advocacy continues, with priorities including Medicaid expansion, telehealth, open enrollment reactivation, health care reform, food security and rollback of preemption law.

With adoption of the “Comprehensive and Coordinated Response to the Coronavirus Disease (COVID-19) Pandemic,” WHO member states are charged with enacting a whole-of-government and a whole-of-society approach to pandemic response and recovery. That means engaging all stakeholders — government, communities, academia, media, the private sector and NGOs and individuals — to combat COVID-19, curb the course of NCDs and build resilience to future pandemics.

This is a watershed moment and what we do today can define our future. The AHA mission embodies our collective vision to build a world of longer, healthier lives.