What question did this study set out to answer?

To assess how hypertension contributes to cardiovascular disease mortality trends in the United States.

March 26, 2026

Contribution of hypertension to recent changes in cardiovascular disease mortality: a population-based study in the United States

Key Result

Cardiovascular disease deaths involving concomitant hypertension increased in the US from 2000 to 2022, rising from 20% to 34.8% of CVD deaths in females and from 16.5% to 36.2% in males.

Key Points

To assess how hypertension contributes to cardiovascular disease mortality trends in the United States.
Designed a sequential time-series analysis
Examined trends in age-standardized mortality rates from 2000 to 2022
Compared mortality rates with and without hypertension as a secondary cause
Calculated the proportionate fraction of deaths attributed to hypertension
CVD-HTN mortality rates among females increased from 47.4 to 52.4 per 100,000 from 2000 to 2022
CVD mortality rates without hypertension for females declined from 189.9 to 98.0 per 100,000 in the same period
CVD-HTN mortality rates for males rose from 67.3 to 96.2 per 100,000 from 2000 to 2022
CVD mortality rates without hypertension for males decreased from 339.4 to 169.9 per 100,000
The proportion of CVD deaths due to hypertension in females increased from 20% to 34.8% and in males from 16.5% to 36.2%

Structured PICO

Population

Individuals aged 18–84 years in the United States

Outcome

Age-standardized cardiovascular disease mortality rates with and without concomitant hypertensionhard clinical

Despite declines in cardiovascular mortality without hypertension, cardiovascular deaths with concomitant hypertension have increased significantly in the US from 2000 to 2022, highlighting a growing public health challenge.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Objectives: Hypertension remains a persistent global challenge and is an essential risk factor for cardiovascular disease (CVD). However, the extent to which hypertension is implicated in CVD mortality in the United States remains unknown. We assessed CVD mortality trends with hypertension as a secondary cause (CVD-HTN) and the proportion of CVD mortality in those with and without secondary hypertension. Methods: We designed a sequential time-series analysis to examine trends in age-standardized mortality rates (18–84 years) with CVD as the underlying cause, with and without concomitant hypertension (as a secondary cause), in the United States from 2000 to 2022. We examined changes in CVD-HTN mortality rates (per 100 000 individuals). We assessed the proportionate fraction of CVD mortality in patients with and without hypertension as a secondary cause. Results: Among females, CVD-HTN mortality rates have increased from 47.4 in 2000 to 52.4 per 100 000 in 2022. CVD mortality rates without concomitant hypertension among females declined from 189.9 in 2000 to 98.0 per 100 000 in 2022. CVD-HTN mortality rates among males increased from 67.3 in 2000 to 96.2 per 100 000 in 2022. CVD mortality rates without concomitant hypertension among males declined over the same period (339.4 in 2000 to 169.9 per 100 000 in 2022). Among females in 2000 and 2022, 20 and 34.8% of CVD deaths were due to concomitant hypertension; among males, these estimates were 16.5 and 36.2%, respectively. Conclusion: The increase in CVD mortality associated with concomitant hypertension is concerning. Public health efforts to mitigate this increase may be worth considering.

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