Trends and disparities in lung cancer and hypertension-related mortality in the United States, 1999–2023.

e23366 Background: Lung cancer remains a primary driver of mortality in the United States, frequently occurring alongside hypertension, which complicates clinical management and significantly worsens patient outcomes. This study aims to analyze and interpret annual mortality trends and disparities among adults in the United States from 1999 to 2023, for various demographic and geographic factors. Methods: The mortality data from the CDC WONDER multiple cause of death files for adults aged ≥25 years were used to analyze age-adjusted and crude mortality rates (AAMRs and CMRs) per 100,000 through ICD 10 code: C34 (lung cancer) and ICD 10 code: I10-I15 (hypertension) stratified by year, gender, race/ethnicity, place of death, and geography. Joinpoint regression was used to estimate average annual percent change (AAPC) and annual percent change (APC) with 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results: From 1999 to 2023, a total of 274,113 deaths were attributed to lung cancer with coexisting hypertension, most occurring at the decedent’s home. The overall AAMR increased from 2.59 in 1999 to 6.05 in 2023 (AAPC: 3.33; 95% CI: 2.27 to 4.41), with the most significant increase observed during the initial years between 1999 and 2001 (APC: 19.43). Men had a higher AAMR than women (5.96 vs 3.92), but the rise in mortality was more pronounced in women compared to men (AAPC: 3.55 vs 3.05). Adults aged 65 years and above had the highest CMR (20.42), with an annual increase of 3.30% (p < 0.001). The highest AAMR was observed among non-Hispanic (NH) Blacks (7.27), while the lowest AAMR was noted among Hispanics or Latinos (2.46). Geographic disparities were evident, with the South having the highest AAMR (5.37) and the Northeast having the lowest (3.96). Non-metropolitan areas had higher AAMR (5.65 vs 4.45) and also showed a sharper increase in mortality than metropolitan areas (AAPC: 4.78 vs 3.12). At the state level, Oklahoma ranked the highest, falling within the top 90th percentile. Conclusions: Mortality related to lung cancer and hypertension has increased over the past two decades, with disproportionate burden among older adults, men, NH Black individuals, and those living in the Southern region and non-metropolitan areas. This underscores the need for targeted prevention strategies and promotion of equitable healthcare services for vulnerable populations. Average annual percent change (AAPC) of age-adjusted mortality rates for Lung Cancer and Hypertension in the United States, 1999 to 2023. Variable Deaths AAPC (95%CI) Overall 274,113 3.33 (2.27 to 4.41) Male 146,982 3.05 (2.06 to 4.05) Female 127,131 3.55 (2.27 to 4.86) Non-metropolitan areas 48,149 4.78 (3.32 to 6.27) Metropolitan areas 175,077 3.12 (2.04 to 4.21)