Evolving Cardiovascular Trends in England: Insights from EHR Data

A landmark analysis of linked EHRs from 57 million people in England found that new cardiovascular diagnoses fell during the initial COVID-19 lockdown and then rebounded—most notably myocarditis and heart failure. That shift altered case mix and the timing of diagnosis, with immediate implications for outpatient workload, inpatient acuity, and population surveillance across pre‑, during‑, and post‑pandemic phases.

The study used linked electronic health records for whole‑population surveillance across defined pre‑, during‑, and post‑COVID windows and examined incidence, prevalence, 30‑day case fatality, and treatment initiation for 79 cardiovascular conditions, as described in the report. Diagnoses dropped during the 2020 lockdown and then rebounded; notable quantitative signals included marked increases in myocarditis incidence and a rise in heart failure prevalence by 2024. Analyses also examined diagnosis‑to‑death intervals and subsequent event rates.

Disparities by ethnicity and socioeconomic status were evident: ethnic minority groups and more deprived populations experienced higher measured burden, divergent incidence trajectories, delayed presentation, and variable treatment uptake. The report highlights higher coronary disease diagnoses in Bangladeshi, Indian, and Pakistani groups and greater hypertension‑related conditions in some Black groups, accompanied by geographic and deprivation‑linked variation in short‑term outcomes.

Healthcare delivery shifts appear central to the detection pattern. Routine detection fell when services were constrained and rebounded as access and clinician focus returned, producing a diagnostic backlog and a relative concentration of higher‑acuity cases. Operational consequences include increased diagnostic workload, the need to triage follow‑up and investigations, and reconsideration of screening intensity, targeted outreach, and resource allocation during recovery—without advocating prescriptive mandates.

Going forward, this analysis supports strengthening EHR‑based surveillance, prioritizing backlog triage for high‑risk diagnoses, and piloting targeted screening and outreach in vulnerable groups to limit downstream morbidity and inform resource allocation during recovery phases.