Epidemiological Trends in Mortality From Acute Myocardial Infarction With Essential and Secondary Hypertension: CDC WONDER Database Analysis, 2000-2024.

BACKGROUND

Acute myocardial infarction (AMI) with essential hypertension (EH) and secondary hypertension (SH) remains a leading cause of mortality. Despite the overall decline, disparities in mortality trends across age group, gender, urbanization, racial, and regional subgroups remain underexplored.

METHODS

Mortality data from the CDC WONDER (2000-2024) were analyzed for AMI (ICD-10 I21) as the primary cause of death and EH (ICD-10 I10) and SH (ICD-10 I15.0, I15.9) as a contributing factor in individuals aged ≥ 25 years. Age-adjusted mortality rates (AAMRs) were standardized to the US 2000 population. Joinpoint regression estimated annual percentage changes (APCs) with 95% confidence intervals (CIs).

RESULTS

AMI with hypertension caused 842,646 deaths, with AAMR declining from 17.63 in 2000 to 12.26 in 2024. Overall, the AAMR showed a significant decline across the study period (AAPC: -1.71%). Males consistently had a higher mean AAMR (18.50) than females (11.82). Upward inflections were noted in the South region during 2018-2021 (APC: 11.17%; p = 0.004), Non-Hispanic Black individuals during 2018-2021 (APC: 9.45%; p = 0.053), metropolitan areas during 2018-2020 (APC: 7.71%; p = 0.038), and among adults aged 65-74 years during 2018-2021 (APC: 7.15%; p = 0.039). State-level variations were observed.

CONCLUSION

Despite the overall decline, rising mortality trends were observed in the Southern region (2018-2021), metropolitan areas, and among individuals aged 65-74 years, highlighting emerging patterns and emphasizing the need for targeted interventions.