Hematologic neoplasms and hypertension: National trends and associations in the United States, 1999–2023 — a CDC wonder analysis

Abstract

Abstract Background: Hypertension is a major contributor to cardiovascular disease and a common comorbidity in patients with hematological cancer. While mortality from each condition is well documented, data on their co-occurrence remain limited. This study examines trends and disparities in cancer-related deaths among individuals with hypertension. Methods: Data analyzed from the CDC WONDER database identified mortality trends in cancer patients aged ≥25 years with hypertension from 1999-2023. Age-adjusted mortality rates (AAMRs) per 100,000 persons, average annual percent change (AAPC), and annual percent change (APC) were calculated and categorized by sex, year, race, geographic location, and age. Results: A total of 142,764 deaths related to hypertension in hematological cancer patients were recorded from 1999-2023 in the U.S. AAMR demonstrated an overall marked rise, from 1.13 in 1999 to 3.87 in 2023 (AAPC: 4.98; 95% CI: 4.36-6.02; p < 0.0000001). Men observed a higher overall AAMR as compared to women (3.11 vs 2.01), subsequently demonstrating a higher mortality (75,287 vs 67,477 deaths). NH White individuals recorded the highest number of deaths (120,748); however, NH Black individuals saw the greatest overall AAMR (3.37), followed by NH White (2.43), and NH Asian/Pacific Islander (1.48). Stratification by census region showed that the highest overall AAMR was exhibited by the Midwest (2.66), followed by the South (2.51), the West (2.50), and the Northeast (2.15). From 1999-2020, metropolitan areas observed a higher overall AAMR as compared to non-metropolitan areas (2.22 vs 0.10), while also exhibiting a greater AAPC of 5.10 (95% CI: 4.22-6.22; p < 0.000001). Older adults saw a higher overall AAMR than middle-aged adults (11.33 vs 0.70). Between 1999 and 2020, AAMR ranged from 4.16 in Oklahoma to 1.16 in Utah. States that were classified in the top 90th percentile were the District of Columbia, Minnesota, Mississippi, Nebraska, Ohio, Oklahoma, and West Virginia, which had roughly double the AAMRs as compared to states that were classified in the lower 10th percentile. Conclusion: Throughout the study timeframe, the burden of hypertension in cancer patients has increased significantly, with disparities observed among different races as well as genders. These findings highlight that there is a need for integrated cardiovascular-oncology care to improve public health.