The contribution of hypertension to mortality in the US: 1968, 1977

The contribution of hypertension to total mortality in the United States in 1968 and 1977 is assessed through multiple cause death rates for all mentions of hypertension and the death certificate prevalence of hypertension. Age-adjusted declines in the hypertension death rates were 32.8 per cent for non-White females, 30.4 per cent for non-White males, 30.3 per cent for White females, and 25.2 per cent for White males. Declines for younger non-Whites were the greatest, about 50 per cent, although their rates were more than twice the White rates in both years. Death certificate prevalence also declined for all four groups with the greatest (16.5 per cent) for non-White males and the least (10.4 per cent) for White males, who only showed declines at older ages. The age trajectory of death certificate prevalence reached a peak at ages 50-69 for non-Whites and ages 60-79 for Whites, with lower prevalence at the most advanced ages. Large declines in the contribution of hypertension to mortality observed in death certificate data are particularly striking in light of the probability that any bias would be toward better detection and reporting over the 10 years.