Abstract Body: Background:
Chronic obstructive pulmonary disease and hypertension are major contributors to cardiopulmonary and vascular morbidity and mortality in the United States. Although mortality trends for each condition have been extensively studied, the long-term national burden associated with their coexistence remains insufficiently characterized. This study examines mortality trends attributed to chronic obstructive pulmonary disease with coexisting hypertension and evaluates demographic and geographic disparities.
Methods:
Mortality data from 1999 to 2023 were obtained from the Centers for Disease Control and Prevention Wide Ranging Online Data for Epidemiologic Research database. Adults aged 25 years and older with death certificates listing both chronic obstructive pulmonary disease and hypertension as underlying or contributing causes of death were included. Age adjusted mortality rates per 100,000 population were calculated using the 2000 United States standard population and stratified by age, sex, race, state, urbanization level, and census region. Temporal trends were assessed using Joinpoint regression with annual percent change estimates.
Results:
A total of 1,001,700 deaths were attributed to coexisting chronic obstructive pulmonary disease and hypertension during the study period. National age-adjusted mortality rates increased more than threefold, rising from 6.23 in 1999 to 21.56 in 2023. Mortality rose sharply between 1999 and 2001, followed by sustained increases through 2011 and persistently elevated rates thereafter, with only modest declines observed after 2021. Rates were consistently higher among males than females. The highest mortality burden was observed among non-Hispanic Black and non-Hispanic White populations, residents of nonmetropolitan areas, and individuals living in the South and Midwest. Mississippi and Oklahoma demonstrated the highest state-level mortality rates.
Conclusions:
Mortality associated with coexisting chronic obstructive pulmonary disease and hypertension has increased substantially over the past two decades, with pronounced racial and geographic disparities. These findings highlight the importance of integrated vascular and pulmonary risk management, improved hypertension control, and region-specific public health strategies to reduce mortality among populations with high-risk cardiopulmonary comorbidity.