A Rising Crisis: Escalating Burden of Diabetes Mellitus and Hypertension-Related Mortality Trends in the United States, 2000–2023

Abstract

Introduction

Diabetes mellitus and hypertension are major contributors to cardiovascular and renal disease mortality, yet their combined long-term impact on mortality trends in the United States remains underexplored. This study evaluates national trends in DM and hypertension-related mortality from 2000 to 2023, analyzing disparities across sex, age groups, race/ethnicity, urbanization, and geographic regions.

Methods

We analyzed mortality data from the CDC-WONDER database, identifying deaths with DM and hypertension as listed causes among adults aged 25 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated, and temporal trends were assessed using Joinpoint regression to determine annual percentage changes.

Results

A total of 2,742,668 DM and hypertension-related deaths were recorded. The AAMR nearly doubled from 33.7 per 100,000 in 2000 to 66.2 per 100,000 in 2023. A sharp increase was observed from 2018 to 2021 (APC: 16.3 [95% CI: 11.8–19.6]), followed by a decline through 2023. Men had consistently higher mortality rates than females. Mortality rates were highest among older adults (65+ years), Non-Hispanic Black individuals, and nonmetropolitan populations. The South had the highest mortality rates, with Mississippi and the District of Columbia reporting the greatest burden.

Conclusions

DM and hypertension-related mortality has significantly increased over the past two decades, with notable demographic and geographic disparities. Public health interventions should prioritize high-risk populations to mitigate mortality trends and improve health equity.