Abstract
Hypertension (HTN) is a leading cause of cardiovascular morbidity and mortality worldwide. Despite advances in treatment, including the development and use of vasodilator-β-blocker combination and treatment with antihypertensive agents, HTN-related deaths have shown concerning trends. As such, the objective of this study is to examine the trends, disparities, and demographic variations in HTN-related mortality over a decade and to identify key factors contributing to these patterns, including genetics, dietary habits, structural discrimination in access to healthcare, lifestyle choices, and secondary hypertension, which is due to underlying conditions like kidney disease, hormonal disorders, or certain medications. To attain this objective, this retrospective study has utilized data from the Center for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to assess HTN-related mortality rates from 2010 to 2020. Age-adjusted mortality rates were calculated, and subgroup analyses were conducted by gender, race/ethnicity, and age groups. Temporal trends were analyzed to identify significant changes in mortality rates over time. Moreover, IBM SPSS Statistics, version 29 (IBM Corp., Armonk, NY) was used in the analysis, while 95% confidence intervals (CIs), were calculated to demonstrate the temporary trend of mortality rates overall and by age, sex, ethnicity, and region. Therefore, the mortality data from 2010 to 2020 show significant trends and variations across demographic groups. Overall, HTN-related mortality rate in the United States increased from 5.1 per 100,000 in 2010 to 6.4 in 2020, reflecting a general upward trend. For males, the rate rose from 4.8 to 6.6 per 100,000 during the same period. Racial disparities are notable, with Black or African American individuals having the highest mortality rates, increasing from 9.6 to 11.2 per 100,000. Age-specific data reveal that mortality in the 65-74 age group more than doubled, from 10.3 to 16.2 per 100,000, while in the 75-84 age group, it rose from 32.1 to 35.7. The 85+ age group had the highest rates, increasing from 144.0 to 155.0 per 100,000. States with the highest age-adjusted rates include Mississippi, Georgia, West Virginia, California, and Alabama. The study findings highlight the growing burden of HTN-related mortality in the United States, particularly among males, racial minorities, and older adults. This situation underscores the need for targeted public health interventions, which include creation of hypertension awareness in minority groups and enhancing medication adherence especially among Blacks, and addressing the social determinants of health contributing to higher HTN rates and poorer outcomes, including disadvantaged neighborhoods, structural discrimination and racism, and limited access to healthcare. The study found that African Americans are likely to be diagnosed with HTN earlier in life with higher HTN-related mortality than Whites, and with 50% increased risk of cardiovascular disease mortality. Continuous efforts are required to aptly address such disparities contributing to ongoing HTN treatment and care inequalities.