Abstract TP122: The Heart Brain Connection Understanding the Impact of Atherosclerosis and Hypertension on Alzheimer's Disease Mortality Trends

Introduction: Alzheimer's disease (AD) is a leading cause of dementia and mortality worldwide.In the United States, AD-related deaths have surged by over 140% between 2000 and 2022. While neurovascular comorbidities such as hypertension and atherosclerosis are known to exacerbate cognitive decline, their specific influence on AD-related mortality remains insufficiently investigated. This study aims to evaluate the impact of these vascular conditions on AD-related mortality across the U.S. population. Methodology: Mortality data from the CDC WONDER database (1999–2020) were analyzed to identify deaths among adults aged 65 and older involving multiple cause-of-death codes for Alzheimer's disease (ICD-10: G30, G30.1, G30.8, G30.9) in conjunction with comorbid hypertension (I10) and ischemic heart disease (I25.0, I25.1). Age-adjusted mortality rates per million population were calculated using the 2000 U.S. standard population as a reference. Temporal trends were evaluated using Joinpoint regression analysis, which estimated annual percent change (APC) and average annual percent change (AAPC), along with corresponding 95% confidence intervals (CIs). Results: From 1999 to 2020, there were 577,577,140 reported deaths from Alzheimer's disease. The age-adjusted mortality rate (AAMR) increased from 47.3 in 1999 to 74.6 in 2020. Between 1999 to 2005, the AAMR rose with an APC of 5.92% (95% CI: 2.70 to 24). After 2015, they resumed an upward trend.Women had higher mortality rates, with an overall AAMR of 65.2 versus 55.7 in men. NH Black or African American individuals had the highest AAMRs at 64.3, followed by NH White at 63, Hispanic at 54.4, American Indian or Alaska Native at 36.8, and Asian or Pacific Islander at 35.0.AAMRs varied by state: from 33.0 in Massachusetts and Nevada to 104.7 in North Dakota. The top 90th percentile states included North Dakota, Mississippi, Vermont, Tennessee, and Oklahoma; the bottom 10th percentile were Massachusetts, Utah, Alaska, Florida, and Hawaii. Conclusion: Alzheimer 's-related mortality in patients with hypertension and atherosclerosis has exhibited an upward trend since 1999 among older adults in the U.S. These findings highlight the urgent need for targeted,population-specific prevention strategies and integrated cardiovascular-neurocognitive care models to reduce mortality and address health disparities.