Mortality trend from multiple myeloma with hypertensive diseases as a contributing cause in the United States, 1999–2024: A CDC WONDER analysis across age, sex, and geographic variables.

e19530 Background: Multiple myeloma (MM) is a malignancy frequently accompanied by comorbid conditions such as hypertensive diseases (HTN), which contribute to end-organ damage and increase mortality risk. However, national trends in MM mortality involving HTN as a contributing cause remain underexplored. This study aims to assess the mortality trends among U.S. adults aged ≥ 55 years from 1999 to 2024, stratified by age, sex, region, and urbanization. Methods: Using CDC WONDER Multiple Cause of Death data, we identified deaths with ICD-10 code C90 (MM) and HTN (I10–I15). Age-adjusted mortality rates (AAMRs) per 100,000 population were computed. Joinpoint regression estimated annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results: A total of 33,341 MM-related deaths with HTN were identified. AAMR increased from 7.5 in 1999 to 26.3 in 2024 (AAPC: 4.64%, 95% CI: 2.63–6.68). Males had higher mortality than females (AAMRs in 2024: 35.3 vs. 19.5; AAPCs: 5.95% vs. 3.60%). Individuals aged 75–85+ exhibited the greatest burden (AAMR: 69.6; AAPC: 5.56%), compared to those aged 55–74 (AAMR: 9.3; AAPC: 3.47%). The South and Midwest experienced the highest AAMRs in 2024 (32.3 and 25.5), with AAPCs of 4.18% and 5.06%, respectively. Urban-rural disparities were noted: non-metropolitan areas had higher AAMRs (26.3) but a lower AAPC (3.65%) compared to metropolitan areas (AAMR: 23.7, AAPC: 5.35%). Oklahoma experienced the largest increase in AAMR, rising from 21.0 (1999–2020) to 67.7 (2021–2024), while Hawaii showed a decline from 17.3 to 13.8 during 2021–2024, Mississippi had one of the highest AAMRs (52.2), whereas Utah reported one of the lowest (10.6). Conclusions: MM mortality involving HTN has increased substantially, with disparities by sex, age, region, and rurality. Recent trends suggest stabilization, yet high-burden populations remain. These findings highlight the need for integrated hypertension management in MM care and targeted public health interventions.