Abstract 4146039: Temporal Trends in Hypertension and Malignant neoplasm-related mortality in the United States: Cross-sectional Analysis of a National Database from 1999 to 2020

Background: While hypertension (HTN) is a major risk factor causing morbidity and mortality following anticancer treatment, the current trends regarding its impact remain unclear.This study utilizes CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) to examine HTN and malignancy-related deaths in the US. Methods: CDC WONDER accessed mortality data for adults aged ≥25 from 1999 to 2020, citing HTN and malignant neoplasms as contributing causes of death. Results, presented as age-adjusted mortality rates (AAMRs) per 100,000, underwent Joinpoint regression for trend analysis and annual percentage change (APC) Results: From 1999 to 2020, 1,067,143 deaths occurred in patients with neoplasms and HTN (AAMR = 22.3, 95% CI: 22.3 - 22.4). Males had higher mortality (AAMR = 27.9) than females (AAMR = 18.4). AAMRs varied across racial groups: highest in non-Hispanic blacks (NHB) (35.9), followed by non-Hispanic Whites (NHW) (21.2), Hispanics (17.9), non-Hispanic American Indian/Alaska Native (NH-AIAN) (16.4), and lowest in non-Hispanic Asian/Pacific Islander (NH-API) (15.3). Region-wise analysis showed that mortality rates were highest in the Midwest region (23.2, 95% CI: 23.1 - 23.3) followed closely by the South region at (23.0, 95% CI: 22.9 - 23.0), and then the West region rates of (22.3, 95% CI: 22.2 -22.4) while the Northeast reported the lowest mortality rate (19.8, 95% CI: 19.7 - 19.9). Mortality rates in rural areas were consistently greater throughout the study period compared to urban areas (Rural: 26.0, 95% CI: 25.8 - 26.1; Urban = 22.2, 95% CI: 22.1 - 22.3). Overall AAMR increased sharply from 12.0 in 1999 to 18.1 in 2001, followed by a gradual increase till 2018 (24.4) and then 29.9 in 2020 (APC: 3.9 [95% CI=3.4,4.4]). AAMR rose in men (APC:4.3), and women (APC: 3.4) throughout the study (FigureA). Across races, NH-AIAN showed the largest increase (APC: 5.5), followed by NHW (APC: 4.4), Hispanic (APC: 4.8), NHB (APC: 2.1), and NH-API (APC: 2.0) (FigureB) Conclusion: Despite recent improvements, HTN-malignancy-related mortality is rising. AAMR increased among men, all racial groups, and those in rural areas. Associated risk factors and examining social determinants of health are crucial for better care