Temporal trends and disparities in mortality from hypertensive heart disease with heart failure: A nationwide analysis (1999–2020)

Introduction

By 2019, nearly 20 million people worldwide had hypertensive heart disease (HHD), resulting in over 1.1 million deaths and 21.5 million disability-adjusted life years (DALYs). Hypertension is a significant factor in heart failure (HF), contributing to about a quarter of cases, increasing to 68 % in older adults. This study examines mortality trends among patients in the United States (US) affected by HHD and HF.

Methodology

This study used Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from 1999 to 2020 to analyze deaths in the United States among adults aged 25 and older from HHD and (congestive) HF (ICD-10 code I11.0). Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age groups, race/ethnicity, geographics, and urbanization status.

Results

Between 1999 and 2020, AAMRs increased from 3.7 to 13.5 per 100,000 population, with a steep increase from 2014 to 2020 (APC: 14.44; 95 % CI: 11.12 to 20.62). Men had slightly higher AAMRs than women (6.3 vs. 6.1). Additionally, AAMRs were highest among non-Hispanic (NH) Black individuals. Non-metropolitan areas had higher AAMRs than metropolitan areas (6.6 vs 6.2). The average AAMR during the COVID-19 pandemic (2020–2022) was nearly three times the pre-pandemic average (1999–2019).

Conclusions

Mortality from combined HHD and HF has risen since 1999, with higher rates among men, NH Black individuals, and those in non-metropolitan areas. Policy changes are needed to address these disparities and enhance healthcare equity.