A MAJOR concern over the past year has been the apparent rise in cardiovascular mortality compared to the pre-pandemic era.

Since March last year, there have been around 10 per cent more deaths than usual in Scotland from "circulatory" causes - heart attacks, strokes, brain haemorrhages, blood clots, heart failure and so forth.

The cause of these "excess" deaths has attracted much speculation - and misinformation.

HeraldScotland: Heart failure mortality rates have increased in the past few years - especially among men over 45Heart failure mortality rates have increased in the past few years - especially among men over 45 (Image: PHS)

Excess deaths are counted by comparing the number of deaths over a fixed period to the average for the previous five years - the latter providing a sort of "expected" benchmark.

In 2022, that meant a comparison with 2016-19 plus 2021 (statisticians excluded 2020 as an aberration).

In the case of circulatory deaths, there were nearly 900 more than expected in the seven months from the beginning of May to the end of December.

READ MORE: Male heart deaths in Scotland at highest number for a decade 

What excess death measurements do less well, however, is to reflect mortality rates and changing demographics.

The PHS reports - while only going up to 2021 for deaths - are useful because they show that while the number of deaths from coronary heart disease, heart failure, heart attacks and strokes increased compared to 2019, the effect was less pronounced after adjusting for age and population size.

That said, in the case of heart failure in men - particularly those in middle age - the mortality rate does appear to have increased significantly between 2019 and 2021.

HeraldScotland: Heart attack rates in Scots aged 0-44 have fluctuated year to year, partly due to comparatively small numbers annually, but there is no overall upward trend which would correlate with Covid vaccines causing sudden cardiac deathsHeart attack rates in Scots aged 0-44 have fluctuated year to year, partly due to comparatively small numbers annually, but there is no overall upward trend which would correlate with Covid vaccines causing sudden cardiac deaths (Image: PHS)

The figures are also useful in disputing claims of a spike in sudden cardiac deaths among young people due to the Covid vaccine - a myth widely spread on social media.

In 2021 - the first full year of the vaccine rollout - the mortality rate from heart attacks among Scots aged 44 and under was 1.4 per 100,000, compared to 1.6 in 2020 (before vaccines) and an average of 1.5 per 100,000 in the eight years before the pandemic.