Abstract 4363024: Longitudinal Trends and Disparities in Hypertension and Hyperlipidemia Related Mortality in the United States from 2000 to 2020

Abstract

Background: Hypertension (HTN) and Hyperlipidemia (HLD) are two modifiable, prevalent risk factors that synergistically contribute to cardiovascular and stroke morbidity and mortality. HLD precedes and exacerbates HTN development by causing endothelial dysfunction and vascular remodeling. This study explored the mortality trends and age-adjusted mortality rates (AAMR) for HLD in hypertensive patients from 2000-2020. Methods: Using the CDC-WONDER database, we selected adults 25 years and older with HTN and HLD. We evaluated AAMR (per 100,000) stratified by year, age, sex, race and geographically. Annual Percent Changes (APC) were calculated using the Jointpoint regression program. Results: From 2000-2020, 849,624 deaths occurred in patients with HTN and HLD. Deaths in decedent’s home were the highest (38.8%), while those in inpatient medical facilities comprised 21.7% of the total. With an overall AAPC of 9.11 (95% CI: 8.59 to 9.63; p = <0.000001), the overall AAMR increased from 5.90 in 2000 to 34.90 in 2020. From 2000 to 2005, a significant rise in overall AAMR is seen (APC: 16.93; 95% CI: 15.33 to 18.55). A modest increase in AAMR is observed from 2005-2011 (APC: 7.53; 95% CI: 6.56 to 8.51). During 2011-2018, slight increases in AAMRs occurred (APC: 2.79; 95% CI: 2.24 to 3.35). A rapid rise was seen from 2018 to 2020 (APC: 18.15; 95% CI: 15.09 to 21.29). Men had higher AAMRs (24.31) in contrast to women (14.47) with a substantial upward trend. Non-Hispanic (NH) Blacks had the highest AAMR (20.41), followed by NH Whites (17.73), NH American Indians (17.22), NH Asian/Pacific Islanders (14.02), and Hispanic/Latino (13.30). State-wise, Vermont had the highest AAMR (35.3), followed by West Virginia (30.8), North Dakota (30), and the least in Nevada (8.7). The West (13.2) and Midwest (12.7) regions had the highest AAMRs. Non-metropolitan (20.20), compared to metropolitan areas (18.54) had higher AAMRs. The 85+ years age group had the highest mortality (30.60%) among all age groups, followed by the 75-84 years age group (29.7%), 65-74 years age group (21.7%) while the 25-54 age groups comprised of the remaining 18% of total. Conclusion: HTN and HLD contribute to a substantial rise in morbidity and mortality in the aging and minorities. The highest mortalities occurred in the elderly, males, NH Blacks, the western region, and non-metropolitan areas. Over the 21-year period, the increasing rates within the disparities highlight the need for tailored approaches.