Abstract PS4-09-20: Trends and Disparities in Mortality Among U.S. Females with Breast Cancer and Hypertensive Diseases, 1999-2023

Abstract Background: Breast cancer remains a leading cause of cancer-related mortality in women, while hypertension is a prevalent comorbidity that can worsen outcomes. Despite their combined clinical significance, national mortality trends in women affected by both conditions remain underexplored. Methods: We analyzed data from the CDC WONDER database for U.S. female decedents aged ≥25 years from 1999 to 2023, using ICD-10 codes C50 (breast cancer) and I10–I15 (hypertensive diseases). Crude death rates (CDRs) and age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Results: From 1999 to 2023, 136,837 deaths were attributed to concurrent breast cancer and hypertensive diseases. Most deaths occurred at home (n=47,612), followed by nursing homes (n=38,608), medical facilities (n=35,200), hospice (n=788), and other locations (n=7,214).The AAMR increased from 2.11 in 1999 to 5.80 in 2023 (AAPC: 4.17%; 95% CI: 3.52–4.94). A sharp rise occurred between 1999–2001 (APC: 27.73%; 95% CI: 13.38–39.55), followed by stability until 2017, then another increase from 2017–2023 (APC: 7.25%; 95% CI: 4.43–15.30).Non-Hispanic Black females had the highest AAMRs (mean: 6.36). Their rates rose from 3.87 in 1999 to 5.95 in 2001 (APC: 18.91%) and from 6.24 in 2018 to 8.36 in 2020 (APC: 17.21%). Non-Hispanic White females experienced an increase from 1.94 in 1999 to 3.18 in 2001 (APC: 28.33%), followed by a slower rise until 2018 (APC: 0.75%) and another jump to 5.12 in 2020 (APC: 12.74%). Among Hispanic women, AAMRs rose from 1.4 in 1999 to 2.85 in 2013 (APC: 3.36%) and again from 2.71 in 2018 to 3.77 in 2020 (APC: 17.99%).No statistically significant AAMR changes were observed in American Indian or Alaska Native women. Asian or Pacific Islander women showed a consistent upward trend (AAPC: 2.68%; 95% CI: 1.93–3.79).Regionally, the Midwest had the highest AAMR (4.24). Trends showed an initial rise (1999–2007; APC: 4.21%), a decline (2007–2016; APC: −2.96%), and a rise again (2016–2023; APC: 4.41%). Similar patterns of increase were observed in the South, West, and Northeast, particularly in the early 2000s and post-2016.Rural areas had higher AAMRs (4.25) than urban areas (3.80). In rural regions, AAMR rose sharply between 1999–2001 (APC: 27.91%) and again between 2018–2020 (APC: 15.31%). Urban areas showed significant increases in similar timeframes.By age group (1999–2023), the highest CDR was in women aged ≥85 years (58.05), followed by ages 75–84 (20.49), 65–74 (7.67), and 55–64 (2.62). Death rates were substantially lower in younger women. Conclusion: Mortality from coexisting breast cancer and hypertensive diseases has risen significantly over two decades, with substantial disparities by race, region, and age. These findings underscore the urgent need for integrated care approaches and equity-focused interventions in this vulnerable population. Citation Format: A. Khan, S. Ali, H. Habib, A. I. Butt, Z. A. Siddiqi, A. Saleem, I. A. Magsi, I. Khan, M. Jan, O. Mohamed, M. Raif, S. Musleh Ud Din, A. Kiamos, S. Streit, A. Castrellon. Trends and Disparities in Mortality Among U.S. Females with Breast Cancer and Hypertensive Diseases, 1999-2023 [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-09-20.