Pulmonary hypertension-related mortality among US adults aged ≥65 years increased 2.6-fold from 5.2 per 100,000 in 1999 to 13.4 in 2020 (AAPC +3.8%; p<0.001), with highest rates in Black individuals.
Observational (n=141,243)
Yes
Pulmonary hypertension-related mortality among older US adults increased significantly from 1999 to 2020, with persistent sex and race-based disparities.
Effect estimate: AAPC +3.8%
Absolute Event Rate: 13.4% vs 5.2%
p-value: p=<0.001
Abstract Rationale Pulmonary hypertension (PH) is a progressive, heterogeneous group of disorders leading to right heart failure and death. Despite advances in management, population-level mortality trends among older adults remain poorly characterized. Understanding these long-term trends is essential for designing equitable, population based interventions. Methods We analyzed mortality data for adults aged 65 years and above using the CDC WONDER database from 1999 to 2020. PH related deaths were identified using ICD 10 codes (I27.0, I27.2,I27.8,I27.9). Age adjusted mortality rates (AAMR) per 100,000 population were calculated and stratified by sex, race and comorbid conditions including hypertension, type 2 diabetes mellitus and congestive heart failure. Temporal trends were evaluated using joinpoint analysis to estimate average annual percent change (AAPC) with corresponding p-values. Results From 1999 to 2020, a total of 141,243 PH related deaths occurred among US adults aged 65 years and above, corresponding to an overall AAMR of 9.1 per 100,000 (95% CI, 8.9-9.3). Annual mortality increased from 5.2 in 1999 to 13.4 in 2020, a 2.6-fold rise (AAPC +3.8%; p 0.001). Females accounted for 63.7% of all PH deaths and had higher mortality than males (10.8 vs 7.2 per 100,000). Black individuals experienced the highest mortality (12.5 per 100,000), exceeding rates among White (8.7) and Hispanic (7.9) counterparts. The proportion of PH deaths associated with cardiometabolic comorbidities rose substantially, with the largest annual increase seen in PH with coexisting HTN (+4.9% per year), followed by CHF (+4.6%) and T2DM (+4.1%). Conclusions Despite therapeutic progress, overall PH related mortality among older U.S. adults rose significantly from 1999 to 2020. Persistent sex and race based disparities highlight inequities in disease burden and access to care. The increasing coexistence of cardiometabolic comorbidities suggests evolving pathophysiology and emphasizes the need for prevention focused, multidisciplinary strategies. Future work should explore modifiable risk factors and healthcare system determinants driving these trends to inform targeted public health and policy interventions. This abstract is funded by: None
Singh et al. (2026) conducted an observational in Pulmonary hypertension (n=141,243). Pulmonary hypertension-related mortality among US adults aged ≥65 years increased 2.6-fold from 5.2 per 100,000 in 1999 to 13.4 in 2020 (AAPC +3.8%; p<0.001), with highest rates in Black individuals.
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