New research compares the rates of cardiovascular disease in people with and without mental health disorders during the COVID-19 pandemic

A new study has found that people with mental health disorders experienced significantly different rates of cardiovascular disease during the COVID-19 pandemic compared to those without, but there was no evidence of existing gaps widening.   

Mental health disorders, like schizophrenia, bipolar disorder, and depression, are linked to a higher risk of premature death and a lower life expectancy, in part due to a higher risk of cardiovascular disease (CVD) compared to the general population. The COVID-19 pandemic disrupted cardiovascular care, raising concerns of health inequalities in general getting wider.

Researchers from the University of Edinburgh, supported by the BHF Data Science Centre, aimed to explore the extent of the differences, or disparities, in CVD rates between people with versus without mental disorders. Specifically, they looked at the rates (known as incidence) of myocardial infarction (heart attack), heart failure, and stroke in England during the COVID-19 pandemic.

Although we know a lot about mental health disparities in CVD, estimates of these differences in countries with universal healthcare were last made a decade ago. This study, which uses data from a UK population, is the first to look at whether the COVID-19 pandemic made disparities worse.

Inside the study

This study used national electronic health data, accessed through NHS England’s Secure Data Environment (SDE). For myocardial infarction, heart failure, and stroke, the researchers summarised the sociodemographic characteristics of patients by mental disorder diagnosis. These characteristics included sex, deprivation, ethnicity, and age.

The team found that CVD incidence was markedly higher in people with schizophrenia, bipolar disorder, and depression, compared to those without these conditions. On average, people with these disorders were diagnosed with CVD 3-10 years earlier than their peers without mental disorders. This gap was largest for heart failure, where people with schizophrenia were on average 10 years younger at diagnosis than those without.

Among individuals with CVD in England, those with a mental disorder were more likely to live in deprived areas, with findings showing between a quarter and a third of people with a mental health disorder and CVD living in the most deprived areas. Looking at ethnicity, the proportion of people with Black, South Asian or mixed ethnicity was greater among those with schizophrenia, but lower among those with bipolar disorder and depression.

Why this matters

Overall, the analysis revealed that, despite CVD incidence being significantly higher in those with mental disorders, there was no evidence of this disparity getting worse during or after the pandemic.

“Our findings highlight an urgent need to address long-standing disparities in cardiovascular disease risk among people living with mental health conditions. This research adds to our understanding of inequalities in CVD and underscores the importance of continued monitoring of the CVD burden in marginalised groups, including those experiencing mental health conditions, so we can better understand the longer-term impacts of the COVID-19 pandemic on cardiovascular health and prevent these gaps from widening further.”

Lead author Kelly Fleetwood