Sajid Maryam, Ali Dua, Qureshi Shaheer, Ahmad Reja, Sajjad Asim, Waqas Saad Ahmed, Ahmed Raheel, Collins Peter
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Department of Medicine, Ziauddin Medical University, Karachi, Pakistan.
Clin Cardiol. 2025 Apr;48(4):e70129. doi: 10.1002/clc.70129.
Hypertension is a major public health concern and a key risk factor for acute myocardial infarction (AMI), significantly contributing to cardiovascular mortality. Despite advancements in management and treatment, trends in associated mortality remain underexplored.
This study examines U.S. national trends in hypertension- and AMI-associated mortality from 2000 to 2023, focusing on demographics and regions.
Age-adjusted mortality rates (AAMRs) per 100,000 for adults aged ≥ 25 with hypertension and AMI were extracted from the CDC WONDER database. Annual percent changes (APCs) and average APCs (AAPCs) with 95% confidence intervals (CIs) were calculated, stratified by year, sex, race/ethnicity, age, urbanization, and Census region.
From 2000 to 2023, 933,024 hypertension- and AMI-related deaths were recorded. Overall, AAMR declined from 19.84 per 100,000 in 2000 to 16.26 in 2023 (AAPC: -0.93%, 95% CI: -1.18% to -0.76%). However, a sharp rise in mortality occurred between 2018 and 2021, coinciding with the COVID-19 pandemic. Stratified analyses revealed persistently higher mortality rates among menmen, non-Hispanic BlackBlack individuals, and residents of the Southern and rural U.S. regions. Younger adults showed an increasing AAMR trend, indicating a growing burden of hypertension and AMI-associated disease.
While long-term mortality trends show a decline, recent years have seen a rise, particularly among high-risk groups. Targeted public health interventions addressing hypertension management, cardiovascular risk reduction, and healthcare disparities are essential to mitigate the ongoing burden of hypertension and AMI mortality in the U.S.
高血压是一个主要的公共卫生问题，也是急性心肌梗死（AMI）的关键风险因素，对心血管疾病死亡率有重大影响。尽管在管理和治疗方面取得了进展，但相关死亡率的趋势仍未得到充分探索。
本研究调查了2000年至2023年美国高血压和AMI相关死亡率的全国趋势，重点关注人口统计学和地区情况。
从美国疾病控制与预防中心（CDC）的WONDER数据库中提取年龄≥25岁的高血压和AMI成年人每10万人的年龄调整死亡率（AAMR）。计算年度百分比变化（APC）和平均APC（AAPC）及其95%置信区间（CI），并按年份、性别、种族/民族、年龄、城市化程度和人口普查区域进行分层。
2000年至2023年期间，共记录了933,024例与高血压和AMI相关的死亡病例。总体而言，AAMR从2000年的每10万人19.84例下降至2023年的16.26例（AAPC：-0.93%，95%CI：-1.18%至-0.76%）。然而，在2018年至2021年期间死亡率急剧上升，这与COVID-19大流行同时发生。分层分析显示，男性、非西班牙裔黑人以及美国南部和农村地区居民的死亡率持续较高。年轻成年人的AAMR呈上升趋势，表明高血压和AMI相关疾病的负担在增加。
虽然长期死亡率趋势呈下降，但近年来有所上升，尤其是在高危人群中。针对高血压管理、心血管疾病风险降低和医疗保健差距的有针对性的公共卫生干预措施对于减轻美国高血压和AMI死亡率的持续负担至关重要。
