Mortality from hypertensive heart disease with co-existing mental disorders increased more than 10-fold in the US between 1999 and 2020, disproportionately affecting men, Black adults, and Southern and urban regions.
Introduction: One of the leading causes of cardiovascular death is hypertensive heart disease (HHD), especially in people who also have behavioral and mental disorders (BMDs). Cardiovascular risk is increased in this population by lifestyle factors, drug side effects, and inflammatory pathways. National data on HHD mortality trends for impacted subgroups in the USA are still scarce, despite the growing burden of both BMDs and HHD. Methods: Using the CDC WONDER Multiple Cause of Death database, we examined death records from 1999 to 2020 in the USA. ICD-10 codes for BMDs (F01–F99) and hypertensive cardiac disease (I11.0–I11.9) were used to identify cases. Regional and demographic-specific age-adjusted mortality rates (AAMRs) were computed. Annual percent changes (APCs) and trends were assessed using joinpoint regression, with significance set at P < 0.05. Results: About 284 797 people died from HHD with accompanying mental illnesses between 1999 and 2020. From 1.15 to 13.69 per 100 000, the AAMR increased (AAPC: 11.65%; P < 0.0001). AAMRs peaked among Black adults and were consistently higher in men. Regional load was largest in the South, and final fatality rates were higher in urban than rural areas. Disparities at the state level varied from 1.40 in Nebraska to 15.71 in Washington, DC. The greatest increases in HHD-related mortality were linked to male sex, substance-related mental illnesses, and living in underserved areas. Conclusion: Men, Black adults, and Southern regions were disproportionately affected by the more than 10-fold increase in mortality from HHD and mental disorders between 1999 and 2020. Urban areas saw the largest increases, underscoring the urgent regional and demographic disparities that require focused interventions.
Imran et al. (Tue,) studied this question.