Abstract Body: Background
We analyzed national mortality involving essential hypertension with obesity to assess temporal trends and disparities. The objective was to characterize changes in age-adjusted death rates and identify demographic and geographic groups with accelerating mortality.
Methods
CDC WONDER multiple-cause mortality data (1999–2020) were used to calculate annual age-adjusted mortality rates for deaths listing essential hypertension with obesity. Analyses were stratified by race/ethnicity, sex, U.S. Census region, state, and urban versus rural residence. Joinpoint regression identified trend change points and estimated annual percent change (APC). Statistical analysis was performed using standard software with assistance from AI tools.
Results
Nationally, hypertension-with-obesity mortality rose gradually during 1999–2018, then surged sharply after 2018 (overall APC modest pre-2018 vs >20% per year in 2018–2020). The most significant increases were in Hispanic and American Indian/Alaska Native adults (APCs ≈77% and ≈43% per year in 2018–2020). Black and Asian populations also showed substantial late increases (37–40% APC), compared to 24% in White adults. Females had a higher late-period APC (33%) than males (~20%), although male AAMRs remained higher overall. Nonmetropolitan (rural) counties had higher mortality rates and earlier trend inflections: by 2020, the rural AAMR (18.1 per 100,000) exceeded the metropolitan rate (12.8).
Conclusions
Mortality involving essential hypertension with obesity has climbed markedly in recent years, particularly among Hispanic and Indigenous communities and in rural areas. These growing disparities highlight critical gaps in addressing coexisting obesity and hypertension. Targeted public health interventions are needed in the most affected populations and regions to improve cardiovascular health equity and reduce preventable hypertension-related deaths.