Abstract FR479: A Quarter Century of Mortality Trends in Hypertension and Sick Sinus Syndrome Among Elderly in the United States
Bibliographic record
Abstract
Background: Hypertension (HTN) and sick sinus syndrome (SSS) are common and often coexisting conditions in the elderly, contributing significantly to cardiovascular morbidity and mortality. Despite advances in management, the long-term mortality trends related to these conditions remain poorly characterized on a national scale. Aim: To analyze 25-year nationwide mortality trends associated with HTN and sick sinus syndrome among U.S. adults aged 65 and older, identifying demographic and regional disparities. Methods: Mortality data from CDC WONDER (1999–2023) were analyzed using Joinpoint regression to assess deaths related to HTN and SSS in U.S. adults aged 65+. Age-adjusted mortality rates (AAMRs) and average annual percent change (AAPC) with 95% confidence intervals were calculated. Results: HTN coexisting with SSS contributed to 27,799 deaths in individuals aged over 65 years. Between 1999 and 2023, the overall AAMR surged from 0.90 to 4.34, with a staggering AAPC of 5.95 (95% CI: 4.70–7.12, p < 0.000001). Females consistently exhibited higher mortality rates than males (AAMR: 3.00 vs. 2.71); however, the trajectory of increase was steeper in males (AAPC: 7.12, 95% CI: 5.45–9.41) compared to females (AAPC: 4.98, 95% CI: 3.58–5.97). Among racial groups, NH Asian or Pacific Islander had the highest AAMR (2.76), followed by NH Blacks (2.53), and NH Whites (2.51). Surprisingly, NH white saw the fastest rise in mortality (AAPC: 6.80, 95% CI: 5.79–7.74), followed by Hispanics (AAPC: 2.41, 95% CI: 1.17–5.78), and NH Blacks (AAPC: (AAPC: 2.26, 95% CI: 1.29–3.28). Among all U.S. census regions, the West faced the highest mortality burden (AAMR: 2.91), followed by the South (2.57). The South saw the most pronounced increase (AAPC: 6.23, 95% CI: 4.39–7.82), followed by the Midwest (AAPC: 5.59, 95% CI: 4.52–7.05), whereas the states with the highest AAMRs were Nebraska (8.05), South Carolina (7.22), and Oregan (6.75). Rural areas exhibited slightly higher AAMRs than urban areas (2.33 vs. 2.20), and the mortality trajectory was also steeper in rural populations (AAPC: 3.64, 95% CI: 4.34–9.15) compared to urban areas (AAPC: 5.04, 95% CI: 3.58–6.37). Conclusion: HTN and SSS-related mortality has escalated over the past 25 years, with the most notable increases seen in males, NH Whites, rural areas, and the South region. These disparities emphasize the urgent need for targeted interventions to address the growing mortality burden, especially among vulnerable populations.
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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 | 0.000 | 0.000 |
| 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".