Trends and Projections for Aortic Stenosis and Hypertension-Related Mortality Among Older Adults in the United States: A Retrospective Population-Based Analysis

Introduction Aortic stenosis (AS) and hypertension (HTN) frequently co-exist in older adults, worsening disease progression and increasing mortality risk compared to either condition alone. Aim To examine mortality trends and demographic-geographic disparities from comorbid AS and HTN in the U.S. from 1999–2020. Methods Data were extracted from the CDC WONDER Multiple Cause of Death database. Crude and age-adjusted mortality rates (CMRs, AAMRs) per 100,000 were calculated. Joinpoint regression estimated annual (APC) and average annual percent change (AAPC). Trends were projected to 2030 using an autoregressive integrated moving average (ARIMA) model. Results Between 1999 and 2020, 100,507 deaths were attributed to comorbid AS and HTN. The overall AAMR significantly increased (AAPC: 5.01%), with a steep rise from 1999–2001 (APC: 21.95%) and consistent increase from 2001–2020 (APC: 3.46%). AAMRs were higher in men (11.6) than women (10.1). NH Whites had the highest AAMR (11.4), followed by Hispanic/Latino and NH Black (7.4), and NH Asian/Pacific Islanders (6.2). AAMRs also varied by region (West: 13.5; Midwest: 11.5; Northeast: 10.7; South: 8.6). Most deaths occurred in medical facilities (34.4%) or at home (31.5%). Vermont, Minnesota, New Hampshire, California, and Nebraska had the highest AAMRs. Non-metropolitan areas had higher AAMRs than metropolitan (11.4 vs. 10.6). Adults ≥ 85 years had the highest CMR (53.6). ARIMA projected AAMR to reach 25.4 by 2030 (22.0 in females, 28.3 in males). Conclusion Mortality from concurrent AS and HTN is rising, with notable demographic and geographic disparities. Early detection, integrated care, and targeted public health strategies are critical. Graphical Abstract