Search

Background: Hypertension-related mortality has been increasing in recent years; however, limited information exists concerning rate, temporal, secular, and geographic trends in the United States., Methods and Results: Using CDC death certificate data spanning 1999-2016, we sought to delineate trends in deaths attributable to an underlying cause of hypertension using joinpoint regression and proportion testing. From 1999-2016, the hypertension-related mortality rate increased by 36.4% with an average annual percent change (AAPC) of 1.8% for individuals ≥ 35 years of age. Interestingly, there was a notable acceleration in the AAPC of hypertension mortality between 2011 and 2016 (2.7% per year). This increase was due to a significant uptick in mortality for individuals ≥ 55 years of age with the greatest AAPC occurring in individuals 55-64 (4.5%) and 65-74 (5.1%) years of age. Increased mortality and AAPC were pervasive throughout sex, ethnicity, and White and American Indian or Alaska Native race, but not Black or African American race. From 2011-2016, there were significant increases in AAPC for hypertension-related mortality with contributing causes of atrial fibrillation, heart failure, diabetes, obesity, and vascular dementia. Elevated mortality was observed for conditions with a contributing cause of hypertension that included chronic obstructive pulmonary disease, diabetes, Alzheimer's, Parkinson's, and all types of falls. Geographically, increases in AAPCs and mortality rates were observed for 25/51 States between 2011 and 2016., Conclusions: Our results indicate hypertension-related mortality may have accelerated since 2011 for middle-aged and older Americans, which may create new challenges in care and healthcare planning., Competing Interests: The authors have declared that no competing interests exist.

Objective: Excess sodium consumption has strong links with hypertension and cardiovascular disease with Food and Drug Association calling to limit sodium intake. However, little is known regarding the trends of sodium intake among hypertensive patients in the United States., Methods: Data from The National Health and Nutrition Examination Survey (1999-2012) were used to identify adults older than 20 years with self-reported hypertension. Sodium intake was measured through 24-h dietary recall. Linear regression was used to assess the time trends of sodium intake., Results: Between the years of 1999 and 2012, sodium consumption increased 14.2% among all adults with hypertension (P = 0.012). The increase was seen in both sexes (by 13.3%, P = 0.023 for male, and by 12.1%, P = 0.015 for female). A significant increase was seen in the amount of sodium consumption among Hispanic (by 26.2%, P = 0.021) and African-American (by 20%, P = 0.031) participants, but not among non-Hispanic whites (by 2%, P = 0.096) during the study period. Participants with higher level of education (3487 ± 1678 vs. 3230 ± 1785 mg, P = 0.002) and household income (3527 ± 1770 vs. 3301 ± 1726 mg, P = 0.009) were found to consume more sodium, which remained significant after adjustment for age., Conclusion: Sodium intake has increased over the last two decades among individuals with hypertension. The increase was especially marked for Hispanics and African-Americans. Improved population-based interventions, including more effective strategies and aggressive approaches to reduce the sodium consumption among hypertensive adults, are needed.