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Temporal Trends and Forecasted Cardiac Arrest and Hypertension-Related Mortality in U.S. Adults, 2000-2035: A
Saifullah Khan1, Fnu Arsheen1, Muneeb Fareed1
1Department of Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Insights
Cardiac arrest with hypertension causes significant and increasing deaths in the U.S. Targeted public health interventions are crucial to address disparities in mortality rates.
Area of Science:
- Cardiovascular Disease Epidemiology
- Public Health Surveillance
- Geriatric Cardiology
Background:
- Hypertension (HTN) and cardiac arrest (CA) intersection is a critical U.S. health issue.
- Combined conditions may worsen outcomes and exacerbate existing disparities.
- This study analyzes national trends and projects future mortality.
Purpose of the Study:
- Characterize national trends in CA with concurrent HTN (2000-2024).
- Project age-adjusted mortality rates (AAMRs) through 2035.
- Identify demographic and geographic disparities in CA mortality.
Main Methods:
- Retrospective analysis of CDC WONDER database (adults ≥25 years).
- Calculated AAMRs and used joinpoint regression for trend analysis.
- Employed Auto-ARIMA and Prophet models for mortality projections.
Main Results:
- 1,693,840 deaths from CA with HTN (2000-2024).
- Overall AAMR increased from 24.56 to 31.68 (AAPC 0.82).
- Highest burden observed in men, non-Hispanic Black adults, older adults, and the West region.
Conclusions:
- CA with HTN presents a substantial and growing mortality burden.
- Significant demographic and geographic disparities persist.
- Continued surveillance and targeted interventions are essential.
Background:
Cardiac arrest (CA) occurring in the setting of hypertension (HTN) represents a critical and under-recognized intersection of acute cardiovascular catastrophe and chronic vascular disease in the United States (U.S.). The coexistence of sudden cardiac dysfunction and long-standing HTN may amplify morbidity and mortality and contribute to persistent demographic and geographic disparities. This study characterizes 2000-2024 national trends in CA with concurrent HTN among U.S. adults and projects age-adjusted mortality rates (AAMRs) through 2035.
Methods:
We conducted a retrospective analysis of Multiple Cause-of-Death data from the CDC WONDER database for CA with HTN mortality among adults aged ≥ 25 years (2000-2024). We calculated AAMRs and used joinpoint regression to estimate annual percent changes (APCs) and the average APC (AAPC) with 95% confidence intervals (CIs). We projected AAMRs through 2035 using Auto-ARIMA and Prophet time-series models in R (v4.5.0) and evaluated model performance using the root mean squared error (RMSE).
Results:
From 2000 to 2024, there were 1,693,840 deaths from CA with concurrent HTN. Overall AAMR rose from 24.56 to 31.68, with an AAPC of 0.82 (p < 0.000001). Men had higher AAMRs than women (overall AAMR: men 32.89; women 25.95). Among races, non-Hispanic (NH) Black/African American adults had the highest mortality (AAMR: 58.25). Older adults (≥ 65 years) bore the highest burden (AAMR: 122.60). Geographic differences were observed, with the West having the highest burden (AAMR: 43.75). Urban areas had higher AAMRs than rural areas (28.88 vs. 25.50). Most deaths (43.78%) occurred in medical facilities. Forecasting to 2035 indicates continued rises, particularly among men, NH Black/African American adults, older adults, West and rural areas.
Conclusion:
CA with concurrent HTN imposes a substantial and rising mortality burden, with pronounced demographic and geographic disparities. Continued surveillance and targeted public-health interventions are warranted.
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