AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Trends and Disparities in Mortality Due to Cardiac Arrest and Hypertensive Renal Disease: A 25-Year Population-Based Analysis (1999-2024)
By Usman MT, Nawaz RN, Malik HMH et al.
Background: Cardiac arrest and hypertensive renal disease are major contributors to cardiovascular mortality in the United States. Hypertension is strongly associated with adverse cardiac and renal outcomes; however, long-term national mortality trends and demographic disparities remain poorly characterized. This study examined the 25-year mortality trends for cardiac arrest and hypertensive renal disease in the United States from 1999-2024. Methods: We conducted a population-based mortality analysis using the CDC WONDER Multiple Cause of Death database (1999-2024). Deaths were identified using ICD-10 codes for cardiac arrest (I46.9) and hypertensive renal disease (I12) as the underlying cause. Individuals aged 25 to 65+ years were included. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Temporal trends were evaluated using Joinpoint regression to estimate annual percentage changes (APCs) and average annual percent changes (AAPCs) with 95% confidence intervals (CIs). Disparities were assessed across age, sex, race/ethnicity, and geographic urbanization. Results: A total of 152,906 deaths were identified. Overall AAMR increased significantly from 0.84 in 1999 to 4.23 in 2024(AAPC 7.48%, 95% CI 6.45-9.13; p<0.001). Mortality increased in both sexes, with a slightly greater annual rise among females (AAPC 6.97%) than males (AAPC 6.58%) (both p<0.001). By race/ethnicity, Black individuals consistently had the highest mortality rates, while White individuals showed the largestrelative increase (AAPC 8.33%, p<0.001). Significant increases were also observed among Black (4.19%), Hispanic (4.36%), and Asian/American Indian/Pacific Islander populations (4.38%) (all p<0.001). Adults aged ≥65 years demonstrated the greatest increase (AAPC 7.22%), followed by those aged 45-64 years (4.75%) and 25-44 years (3.30%). Mortality rose more rapidly in non-metropolitan than in metropolitan areas (AAPC 10.77% vs. 8.19%; p<0.001). Regionally, the Midwest showed the steepest increase (AAPC 9.25%), followed by the West (7.07%), South (6.80%), and Northeast (5.79%). Conclusion: Mortality due to cardiac arrest and hypertensive renal disease increased markedly in the United States over the last 25 years, with disproportionate increases among rural residents, the Midwestern population, and older adults. These findings highlight widening geographic and demographic disparities in cardiorenal disease burden and underscore the need for integrated preventive strategies, improved healthcare access, and targeted public health interventions.