Brain Behav. 2025 Jul;15(7):e70704. doi: 10.1002/brb3.70704.
ABSTRACT
BACKGROUND: Hemorrhagic stroke remains a major cause of mortality, with hypertension being a key modifiable risk factor. Despite advancements in management, demographic and geographic disparities persist. This study aims to analyze hemorrhagic stroke-related mortality trends among hypertensive adults in the United States from 1999 to 2023, stratified by sex, race, and geographic location.
METHODS: We utilized death certificate data from the CDC WONDER database for individuals aged ≥ 25 years from 1999 to 2023. Crude mortality rates (CMR) and Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and annual percentage change (APC) were determined using Joinpoint regression analysis.
RESULTS: From 1999 to 2023, a total of 372,922 deaths were identified related to hemorrhagic stroke and hypertension. The overall AAMR was 0.45 in 1999 and 6.88 in 2023, with no significant trend observed over the study period. Males consistently exhibited higher AAMRs than females (Males: 7.76 vs. Females: 6.06 in 2023). When stratified by race, the highest AAMR was observed in non-Hispanic (NH) Black or African American populations, followed by NH other, Hispanic or Latino, and NH White populations (AAMR of 10.95, 8.20, 7.83, and 5.86, respectively, in 2023). Regionally, the highest mortality was observed in the West, followed by the South, the Midwest, and lastly, the Northeast (with values of 7.91, 7.76, 5.91, and 4.82, respectively, in 2023). Urban areas (6.79) exhibited consistently higher AAMRs than rural areas (6.13) from 1999 to 2020.
CONCLUSION: Hemorrhagic stroke and hypertension-related mortality remained stable in the United States from 1999 to 2023, with males, NH Black or African American populations, and the Western region exhibiting the highest AAMRs. These findings highlight the importance of improving hypertension management and addressing mortality disparities.
PMID:40686020 | DOI:10.1002/brb3.70704
