What question did this study set out to answer?

This study aims to characterize national mortality trends in pulmonary hypertension related to influenza and pneumonia from 1999 to 2023.

May 20, 2026

C67-19 Temporal Trends in Pulmonary Hypertension-related Mortality Associated With Influenza and Pneumonia: A CDC Wonder Analysis (1999-2023)

Key Points

This study aims to characterize national mortality trends in pulmonary hypertension related to influenza and pneumonia from 1999 to 2023.
Extracted mortality data from CDC WONDER database using ICD-10 codes for pulmonary hypertension and respiratory infections.
Calculated crude and age-adjusted mortality rates using the 2000 U.S. standard population.
Assessed temporal trends with Joinpoint regression to estimate annual percent change.
Overall AAPC of +4.53% in PH-related mortality from 1999 to 2023, increasing from 432 deaths (AAMR 4.54) to 1,963 (AAMR 13.22).
Mortality increased significantly among females (AAPC +4.73%) compared to males (+3.57%).
Asian/Pacific Islanders had the steepest rise in mortality rates (+4.06%), especially in nonmetropolitan areas.

Abstract

Abstract Rationale Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder that worsens outcomes in respiratory infections such as influenza and pneumonia. However, national mortality trends in this population remain poorly characterized. This study examined temporal and demographic patterns of PH-related mortality associated with influenza and pneumonia in the United States from 1999 to 2023 to identify vulnerable populations and guide targeted interventions. Methods Mortality data were extracted from the CDC WONDER Multiple Cause of Death database, identifying records with ICD-10 codes for PH (I27.x) and concurrent influenza or pneumonia (J09-J18). Crude and age-adjusted mortality rates (AAMRs) per 1,000,000 population were calculated using the 2000 U.S. standard population. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results Deaths increased from 432 (AAMR 4.54) in 1999 to 1,963 (AAMR 13.22) in 2023. The overall AAPC was +4.53% (95% CI: 3.81-5.57; p 0.001). Mortality rose sharply from 1999-2005 (APC +8.1%), stabilized from 2005-2018 (+1.97%), surged between 2018-2021 (+20.0%), and declined modestly thereafter (2021-2023, −9.9%). Females experienced a greater increase (AAPC +4.73%) than males (+3.57%). Asian/Pacific Islanders showed the steepest rise (+4.06%), followed by Black/African Americans (+2.98%). Regionally, the Northeast and West had higher AAMRs, while nonmetropolitan areas maintained persistently greater mortality burdens. Adults aged ≥75 years accounted for the highest mortality, though increases were observed across all age groups. Conclusions From 1999 to 2023, U.S. mortality from PH associated with influenza and pneumonia more than tripled, peaking between 2018 and 2021. Disproportionate increases among females, Asian/Pacific Islanders, and Northeastern residents reflect persistent disparities linked to insurance and immigration status, healthcare access, and socioeconomic conditions. These findings underscore the need for targeted prevention and equitable resource allocation for high-risk populations. This abstract is funded by: None

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