Cardiovascular

Temporal Trends and Demographic Disparities in Mortality Due to Coronary Artery Disease and Hypertension in Adults Aged 25 and Above in the United States (2000 to 2024).

Tariq M, Khan R, et al. • Clinical cardiology • 2026

TL;DR

CAD and hypertension-related mortality among US adults increased significantly over 25 years (2000–2024), with overall AAMR rising from 57.22 to 76.95, exposing significant demographic disparities across sex, race/ethnicity, geography, and urbanicity.

Key Findings

Methods

Between 2000 and 2024, 3,776,396 deaths occurred due to CAD and hypertension among US adults aged 25 and older.

Data were extracted from the CDC WONDER database using a retrospective study design.
Deaths were identified among adults aged 25 years and older.
Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated.
Temporal patterns and annual percent change (APC) were evaluated using Joinpoint regression analysis.

Results

Overall AAMR for CAD and hypertension mortality rose from 57.22 in 2000 to 76.95 in 2024.

The increase was driven by a steep rise during the 2018–2021 period (APC: 10.13%).
A recent decline followed in the 2021–2024 period (APC: -3.50%).
Despite the recent decline, overall AAMR in 2024 remained substantially higher than the 2000 baseline.
The trajectory of cardiovascular mortality, which historically declined, has plateaued and begun to reverse.

Results

By 2024, male AAMR (106.43) approximately doubled female AAMR (52.68).

This represents a substantial sex-based disparity in CAD and hypertension-related mortality.
The disparity persisted across the full 25-year study period (2000–2024).
Sex differences were identified as a key demographic disparity in the study.

Results

Non-Hispanic African American adults experienced the highest AAMR of any racial/ethnic group at 96.90.

This rate was higher than the overall national AAMR of 76.95 in 2024.
Racial/ethnic disparities were identified as a significant demographic finding across the study period.
The study identified this group as a priority population for targeted public health strategies.

Results

Non-metropolitan areas experienced greater sustained increases in AAMR than metropolitan areas over the study period.

Non-metropolitan areas had an average annual percent change (AAPC) of 2.79%.
Metropolitan areas had an AAPC of 1.23%.
This urbanicity disparity suggests differential access to care or risk factor burden between rural and urban populations.

Results

The South recorded the highest regional AAMR among all US geographic regions.

The South's AAMR was 70.25 with an AAPC of 1.53%.
Regional variation in AAMR was identified as a significant geographic disparity.
The South's AAPC of 1.53% indicates a sustained upward trend in this region over the study period.

Results

Hypertensive heart disease and hypertensive renal disease mortality surged over the study period, while essential hypertension mortality stabilized.

Hypertensive heart disease had an AAPC of 4.35%.
Hypertensive renal disease had an AAPC of 8.83%, the highest of any subtype examined.
Essential hypertension mortality stabilized over the study period.
These subtype-specific trends suggest a shifting burden toward organ-damage manifestations of hypertension.

Results

Chronic ischemic heart disease remained the leading CAD subtype throughout the study period.

Chronic ischemic heart disease had an AAPC of 1.37%.
This subtype maintained the highest mortality burden among all CAD subtypes examined.
The finding was identified using Joinpoint regression analysis of CDC WONDER data from 2000 to 2024.

What This Means

This research suggests that deaths from coronary artery disease (CAD) and high blood pressure (hypertension) in American adults have increased significantly over the past 25 years, despite decades of prior progress in reducing heart disease deaths. Using national death records from 2000 to 2024, researchers found nearly 3.8 million deaths from these causes, with death rates rising sharply—especially between 2018 and 2021—before showing a modest recent decline. The findings reveal stark inequalities: men died at roughly twice the rate of women, Black adults had the highest death rates of any racial group, rural communities saw faster increases than cities, and the South had the highest regional death rates overall. The study also found that certain complications of high blood pressure, particularly kidney disease related to hypertension, are growing much faster than hypertension itself—suggesting that the downstream organ damage from uncontrolled blood pressure is becoming an increasingly serious problem. Meanwhile, chronic ischemic heart disease (reduced blood flow to the heart over time) remained the most common cause of death within the CAD category throughout the entire period. This research suggests that recent gains in cardiovascular health have stalled and, in some groups, reversed. The findings point to the need for public health efforts focused on better blood pressure control and more equitable access to healthcare, particularly in rural areas, the southern United States, and among populations that are disproportionately affected by these conditions.

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Citation

Tariq M, Khan R, Farooq A, Raza K, Athar M, Tariq S, et al.. (2026). Temporal Trends and Demographic Disparities in Mortality Due to Coronary Artery Disease and Hypertension in Adults Aged 25 and Above in the United States (2000 to 2024).. Clinical cardiology. https://doi.org/10.1002/clc.70465

Key Findings

What This Means

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