Long-Term Mortality Trends from Hypertensive Disease with Coexisting Hyperlipidemia: United States, 1999-2023

Hypertensive disease remains one of the leading contributors to cardiovascular morbidity and mortality worldwide, with hyperlipidemia as a major metabolic comorbidity. There is a relative absence of long-term mortality trends that directly assess the co-occurrence of hypertension and hyperlipidemia. We analyzed mortality data from the CDC WONDER platform (1999-2023), including adults aged ≥65 years with hypertensive disorders I10-I15 and hyperlipidemia E78 (E78.0-78.5, E78.8, E78.9) as multiple causes of death. Age-adjusted mortality rates (AAMRs) and average annual percentage changes were calculated using Joinpoint regression, stratified by sex, race/ethnicity, urbanization, region, and age. A total of 960,024 deaths in the United States from 1999 to 2023 were identified. The AAMR per 100,000 ranged from 6.56 [95% confidence interval (CI), 6.29-6.83] in 1999 to 163 (95% CI, 162-164) in 2023. The highest AAMR was reported in 2021, at 164 (95% CI, 163-166). AAMRs were highest among non-Hispanic Black or African American patients. Overall, the mortality rates for both women and men increased steadily over the study period, with men consistently showing higher mortality rates than women. Mortality rates for both women and men increased steadily over the study period, with men showing higher mortality rates than women. Mortality rates from hypertension and hyperlipidemia together have escalated in the United States over the past 25 years. However, the death trends were unequal across demographics, which underscores the necessity for equitable access to medical services and integrated risk reduction to improve cardiometabolic outcomes.