Abstract Body (Do not enter title and authors here): Introduction: Hypertension is considered to contribute to 685,000 deaths annually in the United States as per the CDC. Nearly half of adults (119 million) have high blood pressure which costs the US healthcare system $130 billion annually. We tried to find out the trends of hypertension-related diseases in young and middle-aged people from age 25 to 54 years to see the trends of mortality in the last two decades.

Methods: We used the CDC Wonder database to search for hypertension-led mortality using the ICD code range from I10-I15 from 1999 to 2020. The mortality outcome was reported as an age-adjusted mortality rate (AAMR or AAR). The US standard population of the year 2000 was used and urbanization of 2013 was used. Overall, gender-wise and race mortality data were extracted.

Results: Mortality trends overall as well as for both genders followed an increase throughout the period. Males had a higher AAR (1999 AAR= 10.2, 2020 AAR= 52.3) than the overall numbers (1999 AAR= 8, 2020 AAR= 37.9) and females had below them (1999 AAR= 5.9, 2020 AAR= 23.7) (Figure 1).

Similarly, all the races followed this increasing trend, but blacks had the highest AAR during this period. For blacks, the AAR number doubled from 1999 to 2003 (1999 AAR= 29, 2003 AAR= 58) but after that, till 2019 it remained around 60. From 2019 to 2020 the AAR rose (2019 AAR= 63.3, 2020 AAR= 86.9). The only race to have the biggest increase overall was the American Indians (1999 AAR= 7.5, 2020 AAR= 82.2) because their AAR in 1999 was four times smaller than that of the blacks but in 2020 it ended up very close to that of blacks in early 80’s (Figure 2).

Conclusions: The mortality due to hypertension-related diseases in people aged 25 to 54 years had increased from 1999 to 2020 with males having more mortality than the national average and females and blacks having the highest mortality while the American Indians had the sharpest increase of all the races.