Abstract FR481: A Quarter Century of Cardiovascular Strain: Mortality Trends in Hypertension and Hypertensive Heart Disease Among U.S. Adults Aged 55+

Background: Despite advances in cardiovascular care, hypertension (HTN) and hypertensive heart disease (HHD) remain leading causes of morbidity and mortality in older adults. Understanding long-term mortality trends is essential to inform prevention strategies and health policy. Aim: To assess 25-year nationwide mortality burden related to HTN and HHD in U.S. adults aged 55 and older. Methods: Mortality data from the CDC WONDER database (1999–2023) were analyzed using Joinpoint regression to assess HTN and HHD-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 HHD accounted for 211,963 deaths over 25 years. Between 1999 and 2023, the overall AAMR surged from 0.17 to 20.50, with a staggering AAPC of 14.43 (95% CI: 8.04–24.30; p < 0.000001). Females consistently exhibited higher mortality rates than males (AAMR: 10.77 vs. 9.64); also showing a greater trajectory of increase (AAPC: 15.88, 95% CI: 11.88–23.45) as compared to males (AAPC: 15.71, 95% CI: 9.25–24.76), both with p < 0.000001. When stratified by racial groups, Non-Hispanic (NH) Blacks had a higher AAMR (15.25) compared to NH Whites (10.30). Surprisingly NH White individuals experienced the sharpest rise (AAPC: 16.31, 95% CI: 11.33–24.91, p < 0.000001), followed by NH Blacks populations (AAPC: 10.53, 95% CI: 5.86–17.48, p < 0.000001). Among the regions, The Midwest saw the most notable increase (AAPC: 15.23, 95% CI: 10.16–23.55), followed by the West (AAPC: 15.16, 95% CI: 10.67–23.87). States with the highest AAMRs were Mississippi (29.71) and Nevada (29.52), whereas the lowest AAMRs were seen in Hawaii (7.10) and Connecticut (5.69). Higher AMMRs were seen in rural areas when compared to urban areas (10.14 vs. 8.96). Similarly, the mortality trajectory was more pronounced in rural populations (AAPC: 17.37, 95% CI: 9.41–30.97) compared to urban areas (AAPC: 16.18, 95% CI: 9.52–27.83). The elderly (≥75 years) bore the highest mortality burden, with an AAPC of 15.40 (95% CI: 10.37–23.64). Conclusion: The most notable increases in HTN and HHD-related mortality over the past 25 years, was seen in females, NH Whites, rural areas, Midwest and the elderly. These discrepancies highlight the dire need for targeted interventions to address the growing mortality burden, especially among populations at a greater risk.