Hypertension-Related Mortality in Aortic Dissection and Aneurysm: A Retrospective Observational Study

Hypertension is a major cause of cardiovascular event-related mortality, and its association with aortic aneurysm and dissection is being extensively studied.

To assess mortality trends and demographic disparities in hypertensive diseases with aortic dissection and aneurysm as a contributing cause.

A retrospective observational study was conducted using the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) Multiple Cause of Death (MCD) database to assess mortality trends among individuals aged over 25 years in the United States from 1999 to 2020. Hypertension (ICD-10: I10-I15) was considered the underlying cause of death, with aortic dissection and aneurysm (ICD-10: I71.0) recorded as contributing causes. Data were stratified by gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated.

A total of 20,782 deaths were recorded, with a crude rate of 4.6 per million. The AAMR initially declined (-2.12% APC from 1999 to 2006) but increased significantly from 2006 to 2009 (+56.82% APC). It then decreased slightly from 2009 to 2020 (-0.42% APC). The highest mortality was observed in males (10,902, 52.5%), White individuals (16,551, 79.6%), metropolitan regions (17,426, 83.9%), and medical facilities (13,328, 64.13%). Temporal trends showed an increasing AAMR in both males (+57.22% APC from 2006 to 2009) and females (+56.32% APC from 2006 to 2009). A similar trend was observed during those years in African American individuals (APC +52.45%) and White individuals (APC +57.22%), indicating evolving disparities.

Mortality trends in hypertension with aortic dissection and aneurysm have shifted, with rising disparities in gender, race, geographic areas, and place of death. These findings underscore the need for targeted prevention strategies and improved healthcare access.