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Review
. 2025 Sep 17;87(11):7325-7333.
doi: 10.1097/MS9.0000000000003920. eCollection 2025 Nov.

Trends in hypertensive heart disease-related mortality among population with Alzheimer's in the United States: a 22-year nationwide analysis

Allahdad Khan  1 , Tehreem Asghar  2 , Laiba Yumn  1 , Saniya Ishtiaq  3 , Muhammad Saeed  4 , Rabiah Aslam Ansari  5 , Meenab Fatima  6 , Mohamed Antar  7 , Mobeen Zaka Haider  8 , Muhammad Aamir Laghari  9
Affiliations
Review

Trends in hypertensive heart disease-related mortality among population with Alzheimer's in the United States: a 22-year nationwide analysis

Allahdad Khan et al. Ann Med Surg (Lond). .

Abstract

Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder, while hypertensive heart disease (HHD) is a major cardiovascular condition linked to chronic hypertension (HTN). HTN is common among patients with AD, significantly impacting mortality. This study explores trends in HHD-related mortality among patients with AD in the US from 1999 to 2020, utilizing the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database.

Methods: Data from the CDC WONDER database were used to extract mortality information for individuals aged ≥65 years, with AD and HHD as the underlying or contributing causes of death. Mortality rates were analyzed by age, sex, race/ethnicity, urban-rural classification, and region. Both crude- and age-adjusted mortality rates (AAMRs) were calculated. Joinpoint regression was employed to identify significant trends and changes in mortality over time.

Results: HHD-associated mortality among patients with AD showed a significant upward trend, with deaths rising from 710 in 1999 to 3263 in 2020. The AAMR increased from 2.08 per 100 000 in 1999 to 6.26 per 100 000 in 2020, a threefold increase. Female patients had higher mortality rates than males throughout the study period. The highest mortality rates were observed in the age group of 85+ years, with notable regional disparities, particularly in the South and Midwest. The COVID-19 pandemic in 2020 contributed to a marked spike in mortality.

Conclusion: A concerning rise in HHD-related mortality among patients with AD, particularly in the last decade is observed. Significant disparities exist across demographic groups and regions. These findings highlight the need for public health interventions and policies to address the dual burden of AD and HHD.

Keywords: Alzheimer’s disease; CDC WONDER; hypertensive heart disease; mortality.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Crude death rate per 100 000 individuals stratified by gender/sex in the US, 1999–2020.
Figure 2.
Figure 2.
Age-adjusted mortality rates (AAMRs) per 100 000 individuals stratified by age in the US, 1999–2020.
Figure 3.
Figure 3.
Age-adjusted mortality rates (AAMRs) per 100 000 individuals stratified by census region in the US, 1999–2020.
Figure 4.
Figure 4.
Age-adjusted mortality rates (AAMRs) per 100 000 individuals stratified by urbanization in the US, 1999–2020.
Figure 5.
Figure 5.
Age-adjusted mortality rates (AAMRs) per 100 000 individuals stratified by race/ethnicity in the US, 1999–2020.
See this image and copyright information in PMC

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