Decrease in Adverse Event Reports for Cardiovascular Medications in the Postpandemic Era

The pandemic brought about dramatic changes in the practice of cardiovascular medicine, with many patients delaying care or receiving care remotely. We have previously reported on the impacts of the pandemic on adverse event reports for cardiovascular medical devices; ^, these results suggested that the pandemic was associated with undertreatment of cardiovascular disease. This study seeks to characterize adverse event reports for cardiovascular medications in the postpandemic era because adverse event reports can lend insights into pharmaceutical use along with potential underdiagnosis and undertreatment of cardiovascular disease. The Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) is a comprehensive database of adverse event reports, submitted to the FDA by healthcare professionals, consumers, and manufacturers. This study quantified adverse event reports for cardiovascular medications in 3 classes: platelet aggregation inhibitors—aspirin, clopidogrel, clopidogrel besilate, clopidogrel bisulfate, and clopidogrel hydrochloride; angiotensin-converting enzyme (ACE) inhibitors—enalapril, lisinopril, captopril, benazepril, and ramipril; and β blockers—atenolol, metoprolol, and carvedilol. In each of the 3 classes, the overall adverse event reports decreased in 2021. Clopidogrel medications, a mainstay of treatment for coronary artery disease, showed an overall 27% decrease in adverse event reports from 2020 to 2021. ACE inhibitors, which are used to treat hypertension and heart failure, demonstrated an overall 18% decrease in adverse event reports from 2020 to 2021. Aspirin, an over-the-counter medication widely used for cardiovascular disease prevention, demonstrated a 46% decrease in adverse event reports from 2020 to 2021. Taken together, these results suggest that cardiovascular disease was undertreated and underdiagnosed during the pandemic.