Trends and forecasting of mortality associated with obstructive sleep apnea and hypertension among older adults in the United States (1999-2035)

BACKGROUND: Obstructive sleep apnea (OSA) and hypertension (HTN) frequently coexist and are associated with increased cardiovascular morbidity and mortality in the United States. RESEARCH DESIGN AND METHODS: Mortality data from 1999-2023 were obtained from the CDC WONDER Multiple Causes of Death database. Deaths were identified when ICD-10 codes for OSA (G47.3) and HTN (I10-I15) were listed as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) were calculated and stratified by demographic and geographic factors. Temporal trends were evaluated using Joinpoint regression, and mortality was forecasted using Poisson regression model. RESULTS: A total of 107,514 deaths were associated with OSA and HTN between 1999 and 2023. AAMRs increased from 0.4 in 1999 to 12.4 in 2023, with higher rates observed among males, adults aged ≥75 years, NH-White individuals, rural populations, and residents of the Midwest. Among states, West Virginia had the highest AAMR. Forecasting models project continued increases in overall mortality, with AAMRs reaching 55.38 by 2035. CONCLUSIONS: Mortality associated with OSA and HTN has increased substantially over the past two decades, disproportionately affecting older adults, males, and rural populations. Forecasted trends highlight the need for targeted prevention, early diagnosis, and improved access to effective therapies.