Trends and Projections in Hypertension-Related Mortality in the United States: A 1979-2050 CDC WONDER Analysis.

INTRODUCTION: Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality in the United States. Despite advances in detection and treatment, the burden of hypertension-related deaths continues to challenge public health systems. Understanding long-term mortality trends and projecting future patterns is essential to guide policy, allocate resources, and inform prevention strategies. AIM: This study aimed to examine national trends in hypertension-related mortality in the U.S. from 1979 to 2023 using CDC WONDER data and to project mortality patterns through 2050 to support public health planning and intervention efforts. METHODS: We extracted age-adjusted mortality rates (AAMRs) per 100,000 population for hypertension as the underlying cause of death from the CDC WONDER database. Temporal trends were assessed using Joinpoint regression to identify significant changes in trajectory, calculating the annual percent change (APC) for specific periods and the average APC for broader trends. Future mortality rates were projected through 2050 using time series models trained on 1979-2015 data, validated against data through 2023, and refined using rolling forecasting techniques. RESULTS: From 1979 to 2023, 2,575,968 hypertension-related deaths occurred. AMRs rose from 27.0 (95% CI, 26.7-27.3) to 40.2 (95% CI, 40.0-40.5), peaking in 2020. Males had consistently higher AAMRs than females. In 2023, AAMRs were 46.7 in males and 33.9 in females. Racial disparities persisted, with Black individuals having a higher AAMR than Whites in 2023 (70.2 vs 35.5). The South remained the most affected region, with Oklahoma (164.1), Mississippi (101.7), and Tennessee (86.0) showing the highest AAMRs in 2023. Forecasts indicate rising hypertension-related mortality, with male AAMR reaching 88.8, Black AAMR 68.4, and older adult AAMR 267.5 by 2050. CONCLUSION: Hypertension mortality will remain a major public health issue, with growing sex disparities and high rates in older adults and the South, underscoring the need for targeted, long-term interventions.

Duke Scholars

Author Stephen Greene Medicine, Cardiology

Author Marat Fudim Medicine, Cardiology