Abstract FR571: The Deadly Intersection of Sepsis-Related Mortality and Comorbid Hypertension in US Adults Aged 55 and Older From 1999 Till 2023

Background: Sepsis remains a leading cause of death in older adults, and comorbid hypertension (HTN) may amplify this risk by impairing cardiovascular and immune responses. However, long-term mortality trends in this vulnerable population are not well defined. Aim: To evaluate 25-year trends in sepsis-related mortality among U.S. adults aged 55+ with comorbid HTN. Methods: Mortality data from the CDC WONDER database (1999–2023) were analyzed using Joinpoint regression to assess HTN and sepsis-related deaths among U.S. adults aged 55 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated, along with the average annual percent change (AAPC) and corresponding 95% confidence intervals (CI). Results: HTN among individuals with sepsis accounted for 351,442 deaths over 25 years. From 1999 and 2023, the overall AAMR increased from 8.53 to 26.48, with a staggering AAPC of 4.40 (95% CI: 3.67–5.42, p < 0.000001). Males constantly exhibited higher mortality rates than females (AAMR: 19.55 vs. 17.09); while also showing a steeper increase (AAPC: 5.19, 95% CI: 4.29–6.29) compared to females (AAPC: 3.81, 95% CI: 3.10–4.79,), both with p < 0.000001). Among races, Non-Hispanic (NH) Blacks had the highest AAMR (39.89), followed by Hispanic or Latino (23.73), American Indian (21.75), Asians (16.80) and NH Whites (15.39). Surprisingly NH Whites showed the sharpest rise (AAPC: 5.08, 95% CI: 4.28–6.26, p < 0.000001), followed by American Indians (AAPC: 4.34, 95% CI: 3.61–5.74, p < 0.000001). The region with the highest AAMR was South (20.76), followed by the West (18.75), whereas the states with the highest AAMRs were Oklahoma (65.70), Mississippi (54.37), and South Carolina (45.44). Urban areas exhibited slightly higher AAMRs than rural areas (17.02 vs. 16.16), even though the mortality trajectory was sharper in rural populations (AAPC: 6.10, 95% CI: 4.52–8.09, p < 0.000001) compared to urban areas (AAPC: 4.56, 95% CI: 3.46–5.90, p < 0.000001). Individuals aged ≥75 years exhibited the greater mortality burden, with an AAPC of 4.41 (95% CI: 3.72–5.36, p < 0.000001), which was surprisingly like the rise observed in those aged 55-74 years (AAPC: 4.39, 95% CI: 3.49–5.50, p < 0.000001). Conclusion: HTN and sepsis-related mortality has risen over 25 years, with marked increases among males, NH Whites, elderly, rural areas, Southern and Western regions—highlighting the urgent need for targeted interventions in vulnerable groups.