1999 - 2023年美国高血压疾病及并存肥胖导致的死亡率趋势与差异

Trends and disparities in mortality due to hypertensive disease and coexisting obesity in the USA: 1999-2023.

作者信息

Rao Asad Gul, Parvez Amna, Shahid Sufyan, Pervez Neha, Rana Jamal S, Fudim Marat, Khan Muhammad Shahzeb

机构信息

Dow University of Health Sciences, Karachi, Pakistan.

Liaquat National Hospital, Karachi, Pakistan.

出版信息

Egypt Heart J. 2025 Aug 26;77(1):81. doi: 10.1186/s43044-025-00677-5.

DOI:10.1186/s43044-025-00677-5

PMID:40856971

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12380657/

Abstract

BACKGROUND

Hypertensive disease and obesity frequently coexist and synergistically increase the risk of cardiovascular morbidity and mortality in the USA. Despite this intersection, national trends and disparities in mortality attributable to both conditions remain underexplored.

METHODS

We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database. Hypertensive disease-related deaths with co-listed obesity were extracted for US adults between 1999 and 2023. Age-adjusted mortality rates (AAMRs) were calculated, and Joinpoint regression was used to estimate annual percentage changes (APCs) and identify significant trends.

RESULTS

A total of 412,767 deaths were attributed to hypertensive disease and coexisting obesity from 1999 and 2023. The AAMRs rose nearly tenfold, from 1.3 per 100,000 in 1999 to 13.23 in 2023. While mortality rates increased overtime for both sexes, men consistently exhibited higher rates than women (AAPC: 10.38 vs. 8.15). Older adults (AAMR: 32.63) had the highest mortality, followed by middle-aged (5.56) and young adults (0.71), though young adults saw the steepest relative rise (AAPC: 9.63). Non-Hispanic (NH) Black individuals had the highest mortality (AAPC: 7.78), followed by NH American Indian/Alaska Native (8.76), NH White (9.90), Hispanic (6.48) and NH Asian/Pacific Islander populations (6.51). Geographic disparities widened over time. The South and Midwest bore the heaviest regional burden, while urban-rural analyses showed a higher and quicker rise in mortality in non-metropolitan areas (AAPC: 12.13 vs. 10.73 in metro areas).

CONCLUSION

Mortality due to hypertensive disease with coexisting obesity has escalated sharply across USA over the past 2 decades. These results highlight the need for further investigation into the factors contributing to the observed disparities and trends.

摘要

背景

在美国，高血压疾病和肥胖症经常同时存在，并协同增加心血管疾病发病率和死亡率的风险。尽管存在这种交叉情况，但这两种疾病导致的死亡的全国趋势和差异仍未得到充分研究。

方法

我们使用疾病控制与预防中心的广泛在线流行病学研究多死因数据库进行了一项回顾性分析。提取了1999年至2023年美国成年人中与高血压疾病相关且同时列出肥胖症的死亡病例。计算年龄调整死亡率（AAMRs），并使用Joinpoint回归来估计年度百分比变化（APCs）并确定显著趋势。

结果

1999年至2023年期间，共有412,767例死亡归因于高血压疾病和并存的肥胖症。年龄调整死亡率上升了近10倍，从1999年的每10万人1.3例增至2023年的13.23例。虽然两性的死亡率都随时间增加，但男性的死亡率一直高于女性（年度百分比变化：10.38对8.15）。老年人（年龄调整死亡率：32.63）的死亡率最高，其次是中年人（5.56）和年轻人（0.71），不过年轻人的相对增长率最高（年度百分比变化：9.63）。非西班牙裔（NH）黑人的死亡率最高（年度百分比变化：7.78），其次是NH美洲印第安人/阿拉斯加原住民（8.76）、NH白人（9.90）、西班牙裔（6.4）和NH亚裔/太平洋岛民群体（6.51）。地理差异随着时间的推移而扩大。南部和中西部地区的区域负担最重，而城乡分析显示非大都市地区的死亡率上升更高、更快（年度百分比变化：非大都市地区为12.13，大都市地区为10.73）。