Journal of epidemiology and global health · 2026
Temporal Trends and Forecasted Cardiac Arrest and Hypertension-Related Mortality in U.S. Adults, 2000-2035: A Nationwide CDC WONDER Multiple Cause-of-Death Study.
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Khan Saifullah, Arsheen Fnu, Fareed Muneeb, Mari Tahreem, Hussain Muhammad, Memon Preet, Hussain S M Aleem, Hassan Muhammad, Naz Asma, Ejaz Yusra, Fonarow Gregg C, Aminpoor Hasibullah
Аннотация
BACKGROUND: Cardiac arrest (CA) occurring in the setting of hypertension (HTN) represents a critical and under-recognized intersection of acute cardiovascular catastrophe and chronic vascular disease in the United States (U.S.). The coexistence of sudden cardiac dysfunction and long-standing HTN may amplify morbidity and mortality and contribute to persistent demographic and geographic disparities. This study characterizes 2000-2024 national trends in CA with concurrent HTN among U.S. adults and projects age-adjusted mortality rates (AAMRs) through 2035.
METHODS: We conducted a retrospective analysis of Multiple Cause-of-Death data from the CDC WONDER database for CA with HTN mortality among adults aged ≥ 25 years (2000-2024). We calculated AAMRs and used joinpoint regression to estimate annual percent changes (APCs) and the average APC (AAPC) with 95% confidence intervals (CIs). We projected AAMRs through 2035 using Auto-ARIMA and Prophet time-series models in R (v4.5.0) and evaluated model performance using the root mean squared error (RMSE).
RESULTS: From 2000 to 2024, there were 1,693,840 deaths from CA with concurrent HTN. Overall AAMR rose from 24.56 to 31.68, with an AAPC of 0.82 (p < 0.000001). Men had higher AAMRs than women (overall AAMR: men 32.89; women 25.95). Among races, non-Hispanic (NH) Black/African American adults had the highest mortality (AAMR: 58.25). Older adults (≥ 65 years) bore the highest burden (AAMR: 122.60). Geographic differences were observed, with the West having the highest burden (AAMR: 43.75). Urban areas had higher AAMRs than rural areas (28.88 vs. 25.50). Most deaths (43.78%) occurred in medical facilities. Forecasting to 2035 indicates continued rises, particularly among men, NH Black/African American adults, older adults, West and rural areas.
CONCLUSION: CA with concurrent HTN imposes a substantial and rising mortality burden, with pronounced demographic and geographic disparities. Continued surveillance and targeted public-health interventions are warranted.
METHODS: We conducted a retrospective analysis of Multiple Cause-of-Death data from the CDC WONDER database for CA with HTN mortality among adults aged ≥ 25 years (2000-2024). We calculated AAMRs and used joinpoint regression to estimate annual percent changes (APCs) and the average APC (AAPC) with 95% confidence intervals (CIs). We projected AAMRs through 2035 using Auto-ARIMA and Prophet time-series models in R (v4.5.0) and evaluated model performance using the root mean squared error (RMSE).
RESULTS: From 2000 to 2024, there were 1,693,840 deaths from CA with concurrent HTN. Overall AAMR rose from 24.56 to 31.68, with an AAPC of 0.82 (p < 0.000001). Men had higher AAMRs than women (overall AAMR: men 32.89; women 25.95). Among races, non-Hispanic (NH) Black/African American adults had the highest mortality (AAMR: 58.25). Older adults (≥ 65 years) bore the highest burden (AAMR: 122.60). Geographic differences were observed, with the West having the highest burden (AAMR: 43.75). Urban areas had higher AAMRs than rural areas (28.88 vs. 25.50). Most deaths (43.78%) occurred in medical facilities. Forecasting to 2035 indicates continued rises, particularly among men, NH Black/African American adults, older adults, West and rural areas.
CONCLUSION: CA with concurrent HTN imposes a substantial and rising mortality burden, with pronounced demographic and geographic disparities. Continued surveillance and targeted public-health interventions are warranted.