S1372 Lower Gastrointestinal Bleeding–Related Mortality in US Adults Aged ≥55 With Comorbid Hypertension: A 25-Year Retrospective Analysis

Introduction: Lower gastrointestinal bleeding (LGIB) remains a significant cause of morbidity and mortality among older adults in the United States. Hypertension (HTN), a prevalent comorbidity in this population, may exacerbate bleeding risk through vascular fragility and impaired hemodynamic compensation. Despite growing recognition of the intersection between cardiovascular and gastrointestinal pathology, national data evaluating the burden of LGIB-related mortality among hypertensive individuals remain limited. This study evaluates 25-year trends in LGIB-related mortality among U.S. adults aged ≥55 with comorbid HTN, highlighting disparities across demographic and geographic subgroups. Methods: Mortality data was extracted from the CDC WONDER database (1999–2023) using ICD-10 codes for LGIB and HTN. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression identified Annual Percent Change (APC) and Average Annual Percent Change (AAPC), with P < 0.05 considered significant. Analyses were stratified by sex, age, race/ethnicity, region, urbanization, and state. Results: There were 58,493 LGIB and HTN-related deaths, with 64.3% occurring in inpatient settings. The AAMR rose 122% from 1.66 (1999) to 3.68 (2023) (AAPC: 3.0%, 95% CI: 2.3–4.4, P < 0.000001). Women had a 36% higher mortality rate than men (3.4 vs 2.5), though men showed a faster rise (AAPC: 3.4% vs 2.7%). Adults aged 75+ had much higher AAMRs than those aged 55–74 (8.0 vs 1.2), but the younger group saw steeper increases (AAPC: 3.9% vs 2.7%). Non-Hispanic (NH) Blacks had the highest AAMR (3.5), while NH Whites experienced the sharpest rise (AAPC: 3.4%, P < 0.000001). Regionally, the West had the highest AAMR (3.4), and the South had the steepest increase (AAPC: 3.5%). Rural areas had slightly higher AAMRs than urban areas (3.15 vs 3.04) and a faster rise (AAPC: 3.6% vs 1.9%). States in the top 90th percentile included Rhode Island, South Carolina, Oklahoma, Vermont, and Maryland. Conclusion: LGIB and HTN-related mortality has more than doubled over 2 decades, with steeper increases in men, NH Whites, adults aged 55–74, individuals residing in rural areas and the South region. These findings highlight the need for integrated care strategies for individuals with LGIB and comorbid hypertension, especially in high-risk populations and underserved regions.