Missed routine cardiovascular treatments during the COVID-19 pandemic – Nature.com

The UK’s comprehensive national medical records track health over the life course for >60 million people in England, Scotland and Wales3,4,5. Using these records, we investigated the impact of the COVID-19 pandemic on mediation usage. Specifically, eleven sub-groups of people were analysed, defined by their use of medicines used to treat CVD and its risk factors, such as high blood pressure, high cholesterol and diabetes. Medication records were matched via non-identifying unique pseudo-identifiers to individual-level socio-demographic characteristics. We analysed trends in first (incident) medication use across 1.32 billion records of community-dispensed CVD medications from England, Scotland and Wales between April 2018 and July 2021. By highlighting monthly trends in incident medication use, we aimed to understand the changes in the number of new starters on drugs that are used to control CVD risk factors of diabetes, hypertension and high lipids.

There was a marked decline in the number of CVD preventive medicines dispensed at the start of the COVID-19 pandemic. Specifically, 491,306 fewer individuals initiated antihypertensive treatment than expected based on 2019 levels (Fig. 1). Further analysis revealed that this reduction could result in 13,662 additional CVD events, including 2,281 myocardial infarctions and 3,474 strokes, should individuals remain untreated over their life-course. Incident use of lipid-lowering medicines also decreased by 16,744 patients per month compared with 2019. By contrast, incident use of medicines to treat type 2 diabetes increased by approximately 623 patients per month, although the dispensing of insulin medication remained steady.

Fig. 1: Trends in the count of incident medications dispensed for England, Scotland and Wales.
figure 1

Counts by month for incident medications dispensed for four different subgroups of CVD medication are shown. Vertical dotted lines indicate the timing of the first, second and third national lockdowns on 26 March 2020, 5 November 2020 and 6 January 2021, respectively. © 2022, Dale, C. E. et al.