County‐Level Trends in Hypertension‐Related Cardiovascular Disease Mortality—United States, 2000 to 2019

Abstract

Background Amid stagnating declines in national cardiovascular disease (CVD) mortality, documenting trends in county‐level hypertension‐related CVD death rates can help activate local efforts prioritizing hypertension prevention, detection, and control. Methods and Results Using death certificate data from the National Vital Statistics System, Bayesian spatiotemporal models were used to estimate county‐level hypertension‐related CVD death rates and corresponding trends during 2000 to 2010 and 2010 to 2019 for adults aged ≥35 years overall and by age group, race or ethnicity, and sex. Among adults aged 35 to 64 years, county‐level hypertension‐related CVD death rates increased from a median of 23.2 per 100 000 in 2000 to 43.4 per 100 000 in 2019. Among adults aged ≥65 years, county‐level hypertension‐related CVD death rates increased from a median of 362.1 per 100 000 in 2000 to 430.1 per 100 000 in 2019. Increases were larger and more prevalent among adults aged 35 to 64 years than those aged ≥65 years. More than 75% of counties experienced increasing hypertension‐related CVD death rates among patients aged 35 to 64 years during 2000 to 2010 and 2010 to 2019 (76.2% [95% credible interval, 74.7–78.4] and 86.2% [95% credible interval, 84.6–87.6], respectively), compared with 48.2% (95% credible interval, 47.0–49.7) during 2000 to 2010 and 66.1% (95% credible interval, 64.9–67.1) for patients aged ≥65 years. The highest rates for both age groups were among men and Black populations. All racial and ethnic categories in both age groups experienced widespread county‐level increases. Conclusions Large, widespread county‐level increases in hypertension‐related CVD mortality sound an alarm for intensified clinical and public health actions to improve hypertension prevention, detection, and control and prevent subsequent CVD deaths in counties across the nation.

Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension in the United States

“…There is a critical need for innovative approaches, such as pharmacist-led interventions, to improve BP control. Between 2010 and 2019, there was a 23.1% increase in HTN-related mortality in the US . In 2019, the rate of HTN-related death among Black individuals aged 35 to 64 years was 96.3 events per 100 000—the highest of any race or ethnicity.…”

Toward Precision Medicine: Circadian Rhythm of Blood Pressure and Chronotherapy for Hypertension - 2021 NHLBI Workshop Report

“…35–39 Non-Hispanic Black adults experience the highest rates of hypertension and CVD among all racial/ethnic groups, and there are known health disparities in treatment and CVD outcomes. 40 There is evidence to suggest that African American women and men have a high prevalence of nondipping BP. 41…”

“…[35][36][37][38][39] Non-Hispanic Black adults experience the highest rates of hypertension and CVD among all racial/ethnic groups, and there are known health disparities in treatment and CVD outcomes. 40 There is evidence to suggest that African American women and men have a high prevalence of nondipping BP. 41 Loss or dampening of rhythms, which is one example of circadian disruption, 42 is common in chronic kidney disease (CKD) including loss of the normal circadian rhythm of BP 43 and sleep disturbances.…”

Eliminating hypertension disparities in U.S. non-Hispanic black adults: current and emerging interventions

“…In 2020, age-adjusted hypertension-related NHB adult death rates are approximately twice that of white adults (325.3 for NHB men compared with 175.7 for white men and 216.1 for NHB women compared with 127.9 for white women) [1 ▪▪ ]. In 2019, the highest premature hypertension-related death rates for ages 35–64 years were in the southern US and more than double in black compared with their white counterparts (92.2 per 100 000 and 40.5 per 100 000, respectively) [8 ▪ ].…”