Hypertension and Cardiac Arrest- Related Mortality in the United States: A 24-Year Epidemiological Analysis of Demographic, Geographic, and Temporal Trends (2000-2023)

Abstract Background Hypertension (HTN) affects nearly half of U.S. adults and creates an arrhythmogenic substrate through left ventricular hypertrophy and myocardial fibrosis, increasing cardiac arrest (CA) risk. However, population-level data on HTN and CA-Related mortality trends remain limited. Objective This study aims to assess trends in HTN and CA-Related mortality rates and examine variations by demographics and geographic regions in the United States. Methods Mortality data for adults aged ≥ 25 with HTN and CA-Related conditions were extracted from the CDC WONDER database (2000–2023). Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC) with 95% confidence intervals (CIs) were calculated, stratified by year, sex, race/ethnicity, age, urbanization, and Census regions using Joinpoint regression. Results Between 2000 and 2023, 1,603,971 HTN and CA-Related deaths were recorded. Overall AAMRs increased from 24.56 to 32.83 (AAPC: +1.09%; 95% CI: 0.39–1.79), with modest rises until 2018, a sharp surge during 2018–2021 (APC: +9.24%), and subsequent decline through 2023 (APC: -8.00%). Men consistently had higher AAMRs than women (2023: 38.87 vs 27.56). Non-Hispanic Black adults showed the highest AAMRs (58.43) but experienced slight declines, while young adults (25–44 years) had the steepest proportional increases (AAPC: +3.01%). The West recorded the highest regional AAMRs, and nonmetropolitan areas demonstrated faster growth rates (AAPC: +2.37% vs + 0.81%). Conclusions HTN and CA-Related mortality have increased substantially over two decades, with pronounced disparities by sex, age, race, and geography. The 2018–2021 surge likely reflects COVID-19 impacts, emphasizing the urgent need for targeted HTN control strategies and interventions addressing health equity disparities.