Concurrent aortic stenosis and hypertension: mortality trends in US older adults from 1999–2020

Aortic Stenosis (AS) is a valvular heart disease. Hypertension accelerates stenosis, increasing morbidity and mortality. This study investigates mortality trends in US older adults with AS and hypertension from 1999 to 2020. Using the CDC WONDER database, age-adjusted mortality rates (AAMRs) per 100,000 individuals aged 65+ with AS and hypertension were analyzed. Changes in AAMRs were examined through annual percent change (APC) and average APC (AAPC) using Joinpoint regression. From 1999 to 2020, hypertension caused 99,250 deaths in AS patients in the US, demonstrating an increasing trend (AAPC: 5.51%). Males had higher AAMRs (11.51) than females (9.99). Non-Hispanic (NH) white people (11.32) had the highest AAMRs, followed by Hispanic (7.37), NH Black people (7.27), and NH Asians (6.12). Regionally, the West showed the highest AAMR (13.3), followed by the Midwest (11.38), the Northeast (10.62), and the South (8.53). The states with the highest AAMRs were Vermont and Oregon, while Alabama and Georgia had the lowest. Non-metropolitan areas (11.19) experienced higher mortality than metropolitan areas (10.49). We report increasing mortality rates in patients with AS and hypertension, especially in males, NH white people, and the West. Target healthcare measures are needed to address the rising mortality. This study looked at older adults in the United States who had both aortic stenosis (AS), a condition where the heart’s aortic valve becomes narrow, and high blood pressure. Both conditions are common in people over 65 and can make each other worse, leading to serious heart problems. We used national data from 1999 to 2020 to examine how many people with both conditions died during this time. We found that 99,250 older adults died with both AS and hypertension. Death rates went up over time, especially in men, white individuals, and people living in the Western region of the United States. Rural areas also had higher death rates than urban areas. The highest death rates were in the oldest age group (85+ years). The study suggests that older adults with both AS and hypertension are at greater risk of dying, and this risk is growing. Treatment for high blood pressure in these patients is complicated but important. Differences in access to healthcare, especially in rural areas and among racial groups, may also affect these outcomes. More attention is needed to manage both conditions together, especially in the most affected groups. Understanding these patterns can help doctors and health systems create better plans to care for older adults with heart valve disease and high blood pressure.