ATLANTA, GA — Hypertension-related mortality continues to increase for the US population as well as for several subgroups, including all men older than 45 years, most women, and whites, according to a new report by investigators from the US Centers for Disease Control and Prevention (CDC)1.
The report, which examined hypertension trends between 2000 and 2013, showed that the overall age-adjusted rate for the population during this time rose by 23.1%, while deaths from all other causes combined decreased by 21%. The hypertension-related death rate also increased significantly for men aged 45 to 64 (by 58.2%), 65 to 74 (by 16.5%), 75 to 84 (by 15.3%), and >85 (all P<0.05).
For women, mortality associated with hypertension significantly increased from 2000 to 2013 for those between the ages of 45 and 64 years and for those >85 (both age groups P<0.05).
Rates also increased steadily for whites, fluctuated for Hispanics, and decreased for blacks. Although the latter group still had the highest hypertension-related mortality rate in 2013, "the gap between [them and the other groups] narrowed," note the investigators, led by Dr Hsiang-Ching Kung (CDC's National Center for Health Statistics [NCHS]). The results were released in an NCHS Data Brief.
Increased Death Rates
For the new report, data from the National Vital Statistics System on deaths from any cause were examined. If hypertension was mentioned in any way on a death certificate, it was counted in the hypertension-related mortality rate. "Because about 2% of all decedents with hypertension reported on the death certificate were under age 45," only those over that age were included in the study, report the researchers.
Results showed that the age-adjusted hypertension-related death rate for the full study group was 255.1 per 100 000 population in 2000 vs 314.1 in 2013.
Women between the ages of 75 and 84 years saw a rate increase of 10.9% between 2000 and 2005. The rate started decreasing in 2006, but 2013's rate was still higher than 2000's (689.7 vs 634.7 per 100 000, respectively). The rate for women over 85 years increased 23% between 2000 and 2005 (2003.1 vs 2464.4 per 100 000, respectively) and then increased at a slower rate through 2013 (2549.7 per 100 000). Each year, the women in this age group had higher rates than their male counterparts.
In terms of race, the results showed that blacks had the highest age-adjusted hypertension-related mortality rate every year compared with both whites and Hispanics. The good news, though, is that after increasing between 2000 and 2005 (523.8 vs 559.3 per 100 000, respectively), the rate decreased in 2013 to pre-2000 numbers (509.9 per 100 000).
The news wasn't as good for whites, as their rate of 228.5 per 100 000 in year 2000 marched steadily higher to 296.5 in 2013, for an increase of 29.8%. For Hispanics, their rates increased between 2000 and 2005 (233.7 vs 277.9 per 100 000) before yo-yoing up and down, reaching a rate of 284.8 in 2013.
Finally, one out of six hypertension-related deaths listed hypertension itself as the underlying cause in both 2000 and 2013. Heart disease as the underlying cause accounted for 34.2% of this type of death in 2000 but only for 27.7% in 2013. Rates of stroke as the underlying cause also decreased in the same period, from 14.9% to 9.2%.
"This report reveals a continued rise in the hypertension-related death rate during the 2000–2013 period, following the increase that occurred during the 1980–1998 period," write the investigators, adding that it provides a "comprehensive picture of the burden" of this type of mortality in this country.
Heartwire from Medscape © 2015 Medscape, LLC
Cite this: CDC Report: Hypertension-Related Death Rate Increased 23% Between 2000 and 2013 - Medscape - Mar 30, 2015.