Abstract A144: Trends and Disparities in Hypertension and Intracerebral Hemorrhage-Related Deaths Among Adults in the United States: A CDC WONDER Analysis (2000-2023)

Background: Intracerebral hemorrhage (ICH) in patients with primary hypertension is a leading cause of neurologic death in the United States. Hypertension affects approximately 119.9 million U.S. adults (≈47.7% of adults). The demographic and geographic distribution of ICH-related mortality among those with primary hypertension remains incompletely described. This study characterizes recent trends by sex, race/ethnicity, region,Urbanization and state. Hypothesis: We hypothesized that ICH-related mortality among U.S. adults with primary hypertension changed from 2000 to 2023 and varied by sex, race/ethnicity, and geography. Methods: We analyzed the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause-of-Death dataset ICD-10 Codes ( I61 and I10) for 2000 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated and stratified by sex, race/ethnicity, state, and urban-rural classification. Joinpoint regression estimated average annual percent change (AAPC) and annual percent change (APC)with 95% confidence interval.Statistical significance was defined as p < 0.05. Results: A total of 158,534 deaths were recorded from 2000 to 2023. National AAMR declined from 3.92 in 2000 to 2.45 in 2023, with an overall AAPC of −1.91. Males consistently had higher mortality than females (3.280 vs 2.76), about 1.2 times greater. Racial and ethnic disparities were marked, with non-Hispanic Black adults (4.95), followed by Asian or Pacific Islander adults (4.58), Hispanic adults (3.45), non-Hispanic White adults (2.70), and American Indian or Alaska Native adults (2.20). Regional variation was evident, with the West showing the highest rate (3.63), followed by the South (3.16), the Midwest (2.69), and the Northeast ( 2.47). Metropolitan areas had higher mortality (3.11) compared with non-metropolitan areas (2.99). State-level analysis showed the highest rates in the District of Columbia (5.21), Hawaii (5.07), and California (4.21). while Utah had the lowest rate (1.81). Conclusion: From 2000 to 2023, AAMR for ICH in adults with primary hypertension declined significantly ,but males consistently bore a higher mortality burden than females and marked disparities persist by race/ethnicity and geography notably among Black and Asian populations and in states such as the District of Columbia and Hawaii. These findings support equity-focused, region-specific hypertension prevention.