Temporal trends of mortalities in ovarian carcinoma and hypertension: Comorbidity-related mortality from 1999-2020.

e17590 Background: Ovarian cancer and essential hypertension are both associated with substantial morbidity and mortality in the United States. Hypertension may further worsen outcomes in patients with ovarian cancer, yet population-level mortality patterns remain incompletely characterized. We examined long-term trends and demographic disparities in hypertension-associated mortality among women with ovarian cancer. Methods: We conducted a retrospective population-based cohort study using the CDC WONDER multiple-cause-of-death database (1999–2023). Deaths among women aged ≥45 years with ovarian cancer (ICD-10: C56) and essential hypertension (ICD-10: I10) listed as underlying or contributing causes were identified. Analyses followed STROBE guidelines. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Trends were stratified by age group, race/ethnicity, urbanization, and U.S. census region. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals. Results: From 1999 to 2023, 21,225 deaths occurred among women aged ≥45 years with both ovarian cancer and hypertension (overall AAPC 2.52%; 95% CI 1.19–3.86; p=0.0002). The AAMR increased from 0.71 in 1999 to 1.35 in 2005, declined to 1.19 in 2017, and rose again to 1.47 by 2023. Mortality was higher among women aged ≥65 years (AAPC 1.94%; 95% CI 0.74–3.15) compared with those aged 45–64 years (AAPC 2.95%; 95% CI 1.97–3.94). Non-Hispanic Black women exhibited the highest AAMR (peak 1.86 in 2009; AAPC 1.74%; 95% CI −0.46 to 3.99). Hispanic women demonstrated a gradual increase in AAMR over the study period. Rural areas showed higher mortality rates than urban areas (AAPC 2.47% vs 2.76%), with statistical significance observed for urban trends (p=0.004). Regionally, the South recorded both the lowest AAMR in 1999 (0.58) and the highest in 2022–2023 (1.68). Conclusions: Hypertension-associated mortality among women with ovarian cancer increased from 1999 to 2023, with higher rates among older adults, non-Hispanic Black women, and rural populations. Regional disparities were most pronounced in the Southern United States. These findings support the importance of integrating cardiovascular risk assessment and hypertension management into ovarian cancer care, particularly for high-risk groups. Age-adjusted mortality rate trends for hypertension-related mortality rate among US females with ovarian cancer from 1999 to 2023, stratified by age, race and census region. Serial no. Characteristics AAMR(1999-2023) AAPC (95%CI) JP, No 1 Overall (Female) 0.71-1.47 2.52 (1.19 - 3.86) 2 2 Hispanic 0.9-1.47 1.15 (0.17 - 2.14) 0 3 non-Hispanic black 0.89-1.83 1.74 (-0.46 - 3.99) 2 4 non-Hispanic white 0.68-1.47 2.79 (1.48 - 4.12) 2 5 45-64 year 0.12-0.42 2.95 (1.97 - 3.94) 0 6 65+ year 1.75-3.25 1.93(0.74-3.15) 2 7 Census region 1 0.71-1.14 0.84 (-1.65 - 3.4) 2 8 Census region 2 0.84-1.15 1.33 (-0.17 - 2.86) 3 9 Census region 3 0.58-1.68 2.35 (1.59 - 3.11) 0