Abstract FR481: A Quarter Century of Cardiovascular Strain: Mortality Trends in Hypertension and Hypertensive Heart Disease Among U.S. Adults Aged 55+
Bibliographic record
Abstract
Background: Despite advances in cardiovascular care, hypertension (HTN) and hypertensive heart disease (HHD) remain leading causes of morbidity and mortality in older adults. Understanding long-term mortality trends is essential to inform prevention strategies and health policy. Aim: To assess 25-year nationwide mortality burden related to HTN and HHD in U.S. adults aged 55 and older. Methods: Mortality data from the CDC WONDER database (1999–2023) were analyzed using Joinpoint regression to assess HTN and HHD-related deaths among U.S. adults aged 55 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated, along with the average annual percent change (AAPC) and corresponding 95% confidence intervals (CI). Results: HTN among individuals with HHD accounted for 211,963 deaths over 25 years. Between 1999 and 2023, the overall AAMR surged from 0.17 to 20.50, with a staggering AAPC of 14.43 (95% CI: 8.04–24.30; p < 0.000001). Females consistently exhibited higher mortality rates than males (AAMR: 10.77 vs. 9.64); also showing a greater trajectory of increase (AAPC: 15.88, 95% CI: 11.88–23.45) as compared to males (AAPC: 15.71, 95% CI: 9.25–24.76), both with p < 0.000001. When stratified by racial groups, Non-Hispanic (NH) Blacks had a higher AAMR (15.25) compared to NH Whites (10.30). Surprisingly NH White individuals experienced the sharpest rise (AAPC: 16.31, 95% CI: 11.33–24.91, p < 0.000001), followed by NH Blacks populations (AAPC: 10.53, 95% CI: 5.86–17.48, p < 0.000001). Among the regions, The Midwest saw the most notable increase (AAPC: 15.23, 95% CI: 10.16–23.55), followed by the West (AAPC: 15.16, 95% CI: 10.67–23.87). States with the highest AAMRs were Mississippi (29.71) and Nevada (29.52), whereas the lowest AAMRs were seen in Hawaii (7.10) and Connecticut (5.69). Higher AMMRs were seen in rural areas when compared to urban areas (10.14 vs. 8.96). Similarly, the mortality trajectory was more pronounced in rural populations (AAPC: 17.37, 95% CI: 9.41–30.97) compared to urban areas (AAPC: 16.18, 95% CI: 9.52–27.83). The elderly (≥75 years) bore the highest mortality burden, with an AAPC of 15.40 (95% CI: 10.37–23.64). Conclusion: The most notable increases in HTN and HHD-related mortality over the past 25 years, was seen in females, NH Whites, rural areas, Midwest and the elderly. These discrepancies highlight the dire need for targeted interventions to address the growing mortality burden, especially among populations at a greater risk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".