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Contribution of hypertension to recent changes in cardiovascular disease mortality: a population-based study in the

Cande V Ananth1,2,3,4, Jessica C Fields5,6, Rachel Lee1

  • 1Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

Journal of Hypertension
|March 24, 2026
PubMed

Insights

Cardiovascular disease (CVD) mortality linked to hypertension (HTN) is rising in the US. Public health strategies are needed to address this concerning trend in CVD-HTN deaths.

Area of Science:

  • Cardiovascular medicine
  • Public health
  • Epidemiology

Background:

  • Hypertension is a major risk factor for cardiovascular disease (CVD).
  • The specific impact of hypertension on CVD mortality trends in the U.S. requires further investigation.
  • Understanding the role of hypertension as a secondary cause of CVD mortality is crucial for public health initiatives.

Purpose of the Study:

  • To assess trends in cardiovascular disease (CVD) mortality with hypertension (HTN) as a secondary cause (CVD-HTN) in the United States from 2000 to 2022.
  • To determine the proportion of CVD mortality attributed to concomitant hypertension in males and females.
  • To analyze changes in age-standardized mortality rates for CVD with and without secondary hypertension.

Main Methods:

  • Sequential time-series analysis of U.S. mortality data from 2000 to 2022.
  • Examination of age-standardized mortality rates (18-84 years) for CVD as the underlying cause.
  • Calculation of CVD-HTN mortality rates and the proportionate fraction of CVD deaths with secondary hypertension.

Main Results:

  • CVD-HTN mortality rates increased in both females (47.4 to 52.4 per 100,000) and males (67.3 to 96.2 per 100,000) from 2000 to 2022.
  • The proportion of CVD deaths attributed to hypertension rose significantly in both sexes, reaching 34.8% in females and 36.2% in males by 2022.
  • Conversely, CVD mortality rates without concomitant hypertension declined substantially in both females and males over the study period.

Conclusions:

  • The increasing trend of CVD mortality associated with hypertension is a significant public health concern.
  • These findings highlight the growing burden of hypertension as a contributing factor to cardiovascular deaths.
  • Consideration of targeted public health interventions to mitigate hypertension-related CVD mortality is warranted.
Abstract

Keywords:
cardiovascular diseasehypertensionhypertensive heart diseaseischemic heart diseasestroketrends

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