Raza Ahmed, Kaleem Manal, Shaikh Muhammad Aliyan Ahmed, Mansoor Fatima, Ansab Muhammad, Turkmani Mustafa, Khan Ubaid
Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan.
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
J Clin Hypertens (Greenwich). 2025 May;27(5):e70064. doi: 10.1111/jch.70064.
Hypertension (HTN) is a significant risk factor for heart failure (HF), and both significantly contribute to cardiovascular mortality. This study aims to examine trends and disparities in HF-related mortality among hypertensive older adults (≥65 years) in the United States from 1999 to 2020. Centers for Disease Control and Prevention-Wide-ranging Online Data for Epidemiologic Research (CDC-WONDER) database data were analyzed, focusing on HTN as the underlying cause and HF as the contributing cause of death. Age-adjusted mortality rates (AAMRs) and crude rates were stratified by gender, race/ethnicity, age groups, urban-rural status, and geographic regions. The Joinpoint regression program was used to calculate annual percentage changes (APCs) and average annual percentage changes (AAPCs). A total of 259 079 HF-related deaths occurred among hypertensive older adults, with an overall AAMR increase from 11.27 in 1999 to 41.05 in 2020, indicating a clear upward trend (AAPC: 5.51%). Females had higher AAMRs (28.57) than males (25.56); however, males showed a steeper rise in mortality (AAPC: 6.15% vs. 5.23%). Non-Hispanic Blacks had the highest AAMR (43.99), while NH Whites exhibited the most significant increase (AAPC: 5.92%). Mortality rates were highest in the West (AAMR: 34.57) and lowest in the Northeast (21.44). Non-metropolitan areas had a higher AAMR than metropolitan areas (30.69 vs. 26.52). These findings emphasize the necessity for targeted interventions to diminish disparities and tackle increasing mortality rates in vulnerable populations, especially among women, NH Blacks, individuals in the West, and those living in non-metropolitan areas.
高血压（HTN）是心力衰竭（HF）的一个重要危险因素，二者均对心血管疾病死亡率有显著影响。本研究旨在探讨1999年至2020年美国65岁及以上高血压老年人群中与心力衰竭相关的死亡率趋势及差异。分析了疾病控制与预防中心的广泛流行病学在线研究数据（CDC-WONDER）数据库数据，重点关注以高血压为根本原因、心力衰竭为死亡促成原因的情况。按性别、种族/民族、年龄组、城乡状况和地理区域对年龄调整死亡率（AAMRs）和粗死亡率进行分层。使用Joinpoint回归程序计算年度百分比变化（APCs）和平均年度百分比变化（AAPCs）。高血压老年人群中共有259079例与心力衰竭相关的死亡，总体AAMR从1999年的11.27上升至2020年的41.05，呈明显上升趋势（AAPC：5.51%）。女性的AAMRs（28.57）高于男性（25.56）；然而，男性的死亡率上升更为陡峭（AAPC：6.15%对5.23%）。非西班牙裔黑人的AAMR最高（43.99），而NH白人的死亡率上升最为显著（AAPC：5.92%）。西部地区的死亡率最高（AAMR：34.57），东北部地区最低（21.44）。非都市地区的AAMR高于都市地区（30.69对26.52）。这些发现强调了有针对性干预措施的必要性，以减少差异并应对弱势群体中不断上升的死亡率，特别是女性、NH黑人、西部地区的人群以及居住在非都市地区的人群。
