Abstract 4137949: Trends in Hypertensive Related Heart Disease Mortality Among Older Adults in the United States, 1999 - 2020

Background: Hypertensive heart disease (HHD) is a major global health concern that impairs quality of life and causes significant morbidity and mortality, especially among older adults. We aimed to examine the temporal trends in HHD-related mortality in the United States (U.S.) between 1999 to 2020. Methods: The CDC WONDER multiple-cause of death database was utilized to identify HHD-related mortality among adults aged ≥ 55 years from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, gender, race, and geographic region. Results: A total of 1,186,183 HHD-related deaths were recorded among individuals ≥ 55 years old. Overall, AAMR increased from 36.7 in 1999 to 133.9 in 2020. AAMRs showed a steady increase between 1999 and 2017 (APC: 3.72 [95% CI: 2.72 to 4.49]), followed by a surge from 2017 to 2020 (APC: 14.28 [95% CI: 8.21 to 22.93]). Gender-based analysis showed a constantly higher AAMR among older men compared to older women. Variations in AAMR based on race revealed that Non-Hispanic (NH) Black or African American population had the highest AAMRs. Geographic disparities among states showed that the District of Columbia had the highest AAMR while Nebraska had the lowest. The southern U.S. also had a consistently higher AAMR followed by the West, Northeast, and Midwest. Moreover, metropolitan areas had a higher AAMR than nonmetropolitan areas. Conclusion: Our findings reveal an increase in HHD-related deaths and demonstrate that NH Blacks consistently bear a higher burden of disease mortality. These insights underscore the importance of integrating demographic and geographic variables into public health planning and interventions.