Abstract 4362243: Unseen and Unstoppable: The Burden of Hypertensive Renal Disease in the U.S. - A 22-Year Mortality Analysis (1999–2020)

Background: Hypertensive renal disease (HRD) is a major contributor to chronic kidney disease and closely linked to cardiovascular pathology. The findings aim to assess trends for HRD-related deaths in the United States from 1999 to 2020 and enhance healthcare efforts to reduce HRD-related mortality. Methods: We extracted data from the CDC-WONDER database for individuals aged 25 and above using ICD-10 codes I12.0 and I12.9. Deaths were presented as crude and age-adjusted mortality rates (CMR) (AAMR) per 100,000 population. Joinpoint regression was applied to calculate annual percentage change (APC). Results: From 1999 to 2020, a total of 618,157 deaths occurred from HRD in adults. AAMR started from 5.28 in 1999 and ended at 29.60 in 2020 (Total AAMR: 12.93) [APC: 9.75 (95% CI: 7.87–11.67)]. Females accounted for greater deaths (51.63%) than males (48.37%) but had a lower AAMR (11.12) than males (15.59). Males had a slightly greater increase in AAMR, from 5.95 in 1999 to 34.07 in 2020 [APC: 10.00 (95% CI: 8.06 – 11.98)], whereas AAMR for females went from 4.92 to 25.38 [APC: 9.36 (95% CI: 7.51 – 11.23)]. Among ethnic groups, NH Blacks had the highest AAMR (29.55), starting from 19.11 and ending at 54.79 [APC: 5.25 (95% CI, 3.64–6.89)]. NH Whites had the lowest AAMR (11.04) but the highest percentage rise from 1999 (3.89) to 2020 (26.85) [APC: 11.26 (95% CI, 9.29–13.26)]. Based on age groups, individuals of age 85+ had the most deaths and the highest CMR (39.32%) (203.36), followed by 75-84 years (27.64%) (57.24), 65-74 years (17.13%) (20.75), 55-64 years (9.66%) (7.79), 45-54 years (4.32%) (2.88), 35-44 years (1.49%) (0.99) and 25-34 years (0.44%) (0.30). Regionally, the West had the highest AAMR (14.77), followed by the South (14.02), the Midwest (12.39) and the Northeast (9.59). Metropolitan areas accounted for 82.33% of deaths vs. non-metropolitan areas (17.67%), but both had similar AAMRs: 12.92 and 12.95, respectively. The District of Columbia, Mississippi, and Texas (range: 17.74-23.05) had the highest AAMRs, whereas Connecticut, Massachusetts and Utah had the lowest. Conclusion: Despite advancements in medicine, overall mortality is increasing for HRD-related deaths. Males, NH Blacks and older individuals are disproportionately affected. These disparities highlight the need for targeted public health strategies.