S2679 Trends and Disparities in Liver Disease and Hypertension-Related Mortality in Adults ≥65 Years From 1999 to 2023 in the United States

Introduction: Liver disease (LD) and hypertension (HTN) are both common diseases in the United States that heavily influence mortality patterns in adults. The relationship between LD and HTN is multifactorial. Both conditions have shared risk factors that influence disease progression on one another. HTN leads to hepatic microvascular injury, resulting in inflammation and fibrosis. Conversely, LD may influence HTN, though related mechanisms are poorly understood. This study analyses national LD and HTN-related mortality trends among adults ≥65 years from 1999 to 2023. Methods: The CDC WONDER Multiple-Cause-of-Death dataset (1999–2023) was used to assess mortality trends among adults ≥65 years using International Classification of Diseases, Tenth Revision (ICD-10) codes for LD (K70-K76) and HTN (I10-I15). Data was stratified by place of death, year, sex, race, census region, state, and urbanization. Age-adjusted mortality rates (AAMR) were calculated per 100,000 persons by standardizing crude mortality rates (CMR) with 95% confidence intervals (95% CI). Average annual percent change (AAPC) was calculated via the Joinpoint regression model, with statistical significance defined as P < 0.05. Results: A total of 112,506 LD and HTN-related deaths occurred from 1999 to 2023, mainly in medical facilities (38.0%). Overall, AAMR rose from 3.9 in 1999 to 20.3 in 2023 (AAPC: 6.8; 95% CI: 6.3 to 7.3). In terms of age group, adults ≥85 years had the highest average CMR, along with the highest rate of increase (AAPC: 7.4; 95% CI: 6.3 to 8.8). Men, in comparison to women, had higher average AAMR, along with a higher rate of increase (AAPC: 7.5; 95% CI: 6.9 to 8.1). Racially, Hispanic/Latinos had the highest average AAMR, while non-Hispanic (NH) Whites had the highest rate of increase (AAPC: 7.3; 95% CI: 6.8 to 7.9). Regionally, the West had the highest average AAMR, while the South had the highest rate of increase (AAPC: 7.2; 95% CI: 6.8 to 7.8). State-wise, California had the highest percentage of deaths (14.96%). From 1999 to 2020, rural areas, in comparison to urban areas, had higher average AAMR, along with a higher rate of increase (AAPC: 7.4; 95% CI: 6.7 to 8.6). Conclusion: LD and HTN-related mortality among adults ≥65 years increased from 1999 to 2023, with marked disparities across demographic and geographic groups. Such disparities magnify the urgency for targeted interventions and public health policy changes to decrease the mortality burden as a whole and especially among high-risk groups.