Trends in hypertension- and dementia-related mortality in the United States: An observational analysis from 1999 to 2020

Hypertension (HTN) has long been linked to an increased risk of cognitive decline, and recent years have seen a concerning parallel rise in deaths related to both HTN and dementia in the United States. This study aimed to assess demographic and regional differences in HTN- and dementia-related mortality from 1999 to 2020. We used data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to analyze deaths involving both HTN and dementia. Age-adjusted mortality rates (AAMR) and average annual percent change (AAPC) were calculated and stratified by year, sex, race and ethnicity, age group, and geographic region. From 1999 to 2020, a total of 1,266,684 HTN- and dementia-related deaths were recorded. The AAMR increased from 16.7 in 1999 to 128.2 in 2020 (AAPC = 8.05%, P < .001), with notable surges in 1999 to 2001 and 2018 to 2020. Women had higher mortality than men (135.6 vs 113.3). Non-Hispanic (NH) Black individuals had the highest rate (115.5), followed by NH White (78.6) and Hispanic individuals (69.2), with Hispanics showing the steepest relative rise. The greatest increase occurred in adults aged 85 years and above, particularly in the Southern (87.1) and rural (85.8) regions. HTN- and dementia-related mortality continues to rise, highlighting widening demographic disparities and the urgent need for equitable preventive health strategies.