Keywords
Renal disease
Mortality trends
Age-adjusted mortality
Health disparities
How to Cite
Abstract
Background: Hypertensive heart and renal disease remain major contributors to mortality in the United States. Tracking long-term mortality patterns is essential for identifying high-risk populations and guiding public health strategies.
Methods: We conducted a nationwide ecological time-trend analysis using CDC WONDER underlying cause-of-death data for Hypertensive Heart and Renal Disease (ICD-10 I13) from 1999–2023. Age-adjusted mortality rates (AAMR) for all ages were examined by sex, race/ethnicity, census region, and urbanization level. Temporal changes were assessed using joinpoint regression with annual percent change (APC) and average annual percent change (AAPC).
Results: AAMR increased from 1.2 (95% CI: 1.2–1.3) per 100,000 in 1999 to 4.2 (95% CI: 4.2–4.3) in 2023. After relative stability in the early years, a marked rise began around 2011, with the South and Midwest showing the steepest increases. From 2013–2023, the AAPC was not statistically significant for females (AAPC = 6.26%; p = 0.1678) but was significant for males (AAPC = 10.67%; p = 0.000117). Males(with AAMR of 4.7 vs 3.9 in females in 2023), older adults, and Black individuals consistently exhibited the highest mortality, while American Indian or Alaska Native groups experienced the most rapid recent increases. A modest decline from 2021–2023 was observed; potential explanations include shifts in healthcare access, reporting, or coding practices.
Conclusions: Rising mortality from hypertensive heart and renal disease from 1999 to 2023 highlights persistent demographic and geographic disparities requiring targeted interventions.
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Copyright (c) 2026 Ahmad Jalil, Fatima Rajab, Bisal Naseer, Aleena Mujahid, Mohsan Ali, Hadia Rajab, Justin May