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Mortality trends associated with hypertension and atrial fibrillation: A CDC WONDER data analysis

Saad Khan¹, Usama Idrees², Safa Nasir³

¹Saidu Medical College, Department of Internal Medicine, Saidu Shareef, Mingora City, District Swat, KPK 19130, Pakistan.

Global Epidemiology

|October 23, 2025

Insights

Mortality from hypertension (HTN) and atrial fibrillation (AF) is rising nationwide. Significant disparities exist across demographics, highlighting the urgent need for targeted public health interventions and improved cardiovascular care access.

Area of Science:

Cardiovascular Epidemiology
Public Health Research
Health Disparities

Background:

Hypertension (HTN) and atrial fibrillation (AF) are common cardiovascular conditions linked to increased risks of stroke, heart failure, and mortality.
Existing research lacks comprehensive data on US mortality trends and demographic disparities associated with combined HTN and AF.

Purpose of the Study:

To analyze national mortality trends attributed to HTN and AF from 1999 to 2020.
To identify and examine disparities in HTN-AF mortality across various demographic groups.
To inform public health strategies for screening and treatment.

Main Methods:

Utilized CDC WONDER database for mortality data (1999-2020).
Analyzed age-adjusted mortality rates (AAMR) and crude mortality rates (CMR).
Stratified data by gender, age, race/ethnicity, and geographic region; employed Joinpoint software for trend analysis.

Main Results:

Age-adjusted mortality rates (AAMR) due to HTN-attributable factors significantly increased from 2.89 to 23.98 per 100,000 (APC: 4.8%).
Males exhibited higher AAMRs than females; Black or African American populations experienced the steepest increases.
The Western US region reported the highest AAMR, with rural and micropolitan areas showing the most substantial increases in mortality rates.

Conclusions:

HTN-AF mortality shows a consistent upward trend across all demographic segments.
Addressing healthcare policy gaps, enhancing public awareness, and promoting cardiovascular health initiatives are critical.
Reducing HTN-AF-related mortality necessitates tackling healthcare access disparities and implementing targeted interventions.

Read full analysis

Abstract

Background:

Hypertension (HTN) and atrial fibrillation (AF) are prevalent cardiovascular disorders that significantly increase the risk of serious complications such as stroke and heart failure, leading to elevated mortality rates. Despite the established relationship between HTN and AF, there is a lack of comprehensive evidence on mortality trends and disparities across various demographic groups in the United States.

Objectives:

This study aims to analyze the nationwide mortality trends due to HTN-AF from 1999 to 2020 and to identify disparities across different demographics. The goals include understanding the impact of HTN-AF on public health and informing targeted screening and therapeutic strategies.

Methods:

Data on mortality figures related to HTN and AF were obtained from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. The analysis included age-adjusted mortality rates (AAMR) and crude mortality rates (CMR) stratified by gender, age, race/ethnicity, and geographic regions. The Joinpoint software was used to analyze temporal trends in age-adjusted mortality rate (AAMR). Data were obtained from publicly available multiple causes of death records via the CDC WONDER database.

Results:

From 1999 to 2020, the AAMR due to hypertension-attributable factors rose sharply from 2.89 to 23.98 per 100,000 (APC: 4.8 %). Males had higher AAMRs than females, with Black or African American populations seeing the steepest increases. Regionally, the West had the highest AAMR, and rural areas experienced the most significant rise, with micropolitan areas showing the highest APC.

Conclusion:

HTN-AF mortality has been increasing steadily across all genders, races, and regions. The study underscores the importance of improving healthcare policies, bridging coverage gaps, and enhancing education and awareness to curb these alarming trends. Addressing the disparities in healthcare access and promoting cardiovascular health initiatives are crucial for reducing HTN-AF-related mortality.

Keywords:

Atrial fibrillation CDC WONDER Hypertension Mortality United states

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