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. 2022 Apr 1;5(4):e228031.
doi: 10.1001/jamanetworkopen.2022.8031.

Association of the 2020 US Presidential Election With Hospitalizations for Acute Cardiovascular Conditions

Matthew T Mefford  1 , Jamal S Rana  2   3 , Kristi Reynolds  1   4 , Omesh Ranasinghe  1 , Murray A Mittleman  5   6 , Jennifer Y Liu  3 , Lei Qian  1 , Hui Zhou  1 , Teresa N Harrison  1 , Alan C Geller  7 , Richard P Sloan  8 , Elizabeth Mostofsky  5 , David R Williams  7   9 , Stephen Sidney  3
Affiliations

Association of the 2020 US Presidential Election With Hospitalizations for Acute Cardiovascular Conditions

Matthew T Mefford et al. JAMA Netw Open. .

Abstract

Importance: Prior studies found a higher risk of acute cardiovascular disease (CVD) around population-wide psychosocial or environmental stressors. Less is known about acute CVD risk in relation to political events.

Objective: To examine acute CVD hospitalizations following the 2020 presidential election.

Design, setting, and participants: This retrospective cohort study examined acute CVD hospitalizations following the 2020 presidential election. Participants were adult members aged 18 years or older at Kaiser Permanente Southern California and Kaiser Permanente Northern California, 2 large, integrated health care delivery systems. Statistical analysis was performed from March to July 2021.

Exposure: 2020 US presidential election.

Main outcomes and measures: Hospitalizations for acute CVD around the 2020 presidential election were examined. CVD was defined as hospitalizations for acute myocardial infarction (AMI), heart failure (HF), or stroke. Rate ratios (RR) and 95% CIs were calculated comparing rates of CVD hospitalization in the 5 days following the 2020 election with the same 5-day period 2 weeks prior.

Results: Among 6 396 830 adults (3 970 077 [62.1%] aged 18 to 54 years; 3 422 479 [53.5%] female; 1 083 128 [16.9%] Asian/Pacific Islander, 2 101 367 [32.9%] Hispanic, and 2 641 897 [41.3%] White), rates of hospitalization for CVD following the election (666 hospitalizations; rate = 760.5 per 100 000 person-years [PY]) were 1.17 times higher (95% CI, 1.05-1.31) compared with the same 5-day period 2 weeks prior (569 hospitalizations; rate = 648.0 per 100 000 PY). Rates of AMI were significantly higher following the election (RR, 1.42; 95% CI, 1.13-1.79). No significant difference was found for stroke (RR, 1.02; 95% CI, 0.86-1.21) or HF (RR, 1.18; 95% CI, 0.98-1.42).

Conclusions and relevance: Higher rates of acute CVD hospitalization were observed following the 2020 presidential election. Awareness of the heightened risk of CVD and strategies to mitigate risk during notable political events are needed.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Mittleman reported receiving grants from the National Institutes of Health and grants from the Patient-Centered Outcomes Research Institute outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Hospitalization for Acute Cardiovascular Disease (CVD) Events per 100 000 Person-Years in the Month Preceding and After the 2020 Presidential Election
Rates of composite cardiovascular disease events per 100 000 person years are presented 30 days before and after the date of the 2020 presidential election (0 = date of the 2020 presidential election). Absolute event rates are presented by a dashed line, with a 7-day smoothing average presented as a solid line. Rates in the risk window (November 4-8) and the control window (October 21-25) are highlighted.
Figure 2.
Figure 2.. Hospitalization for Acute Myocardial Infarction (AMI), Stroke, and Heart Failure (HF) Events per 100 000 Person-Years in the Month Preceding and After the 2020 Presidential Election
Rates of AMI (panel A), stroke (panel B), and HF (panel C) per 100 000 person years are presented 30 days before and after the date of the 2020 presidential election (0 = date of the 2020 presidential election). Absolute event rates are presented by a dashed line, with a 7-day smoothing average presented as a solid line. Rates in the risk window (November 4-8) and the control window (October 21-25) are highlighted.
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