Abstract Body:
Introduction:
Essential hypertension and type 2 diabetes mellitus are highly prevalent comorbidities with rising mortality in older adults. However, the extent of temporal and demographic variations remains incompletely understood.
Hypothesis: We assessed the hypothesis that age-adjusted mortality rates (AAMRs) for these conditions significantly increased from 1999 to 2024, with variation by sex, race/ethnicity, region, and urbanization.
Methods:
We analyzed mortality data for adults ≥65 years from the Centers for Disease Control and Prevention, including those with essential hypertension and type 2 diabetes as an underlying or contributing cause of death. Joinpoint regression was performed to identify annual percentage changes (APCs) and determine inflection points. Statistical significance was set at P<0.05.
Results:
Total mortality counts were aggregated, reflecting a substantial burden among older adults. Nationally, AAMRs rose sharply (APC ~60%) between 1999 and 2001, followed by a more moderate but significant increase (APC ~2–4%) into the mid-2010s. From about 2016 to 2021, rates accelerated further (APC ~12–15%), then showed a slight plateau or decline after 2021. Males experienced higher APCs than females in several periods. Regional differences were pronounced in the South and West, with American Indian or Alaska Native populations and Hispanics displaying large early increases but subsequent downturns after 2021. Urban–rural comparisons revealed greater early rises in non-metropolitan areas (APC >70%), with more modest increases in later years.
Conclusions:
Among older adults, mortality from essential hypertension and type 2 diabetes increased considerably from 1999 to 2021, with significant demographic disparities. A recent plateau or decline may be emerging, warranting further study and targeted interventions for high-burden subgroups.