Hypertensive heart disease and chronic kidney disease: a mortality analysis of high-risk populations using CDC WONDER

Abstract Introduction Chronic kidney disease (CKD) and hypertensive heart disease (HHD) are significant public health concerns due to their disproportionate impact on high-risk populations and increasing mortality rates. Utilizing data from the CDC WONDER database, our objective is to analyze mortality rates for HHD and CKD from 2010 to 2020, with a specific focus on changes related to race, gender, urbanization, location, and overall health. The aim is to identify demographic differences and fluctuations in death rates over time to inform targeted public health efforts. Method Data related to mortality was extracted from the CDC WONDER. The analysis of Multiple Cause of Death Files was conducted from 1999 to 2020 to identify fatalities associated with Hypertensive Heart Disease and Chronic Kidney Disease. Crude rates and age-adjusted mortality rates (AAMRs) per 100,0000 populations were calculated for variables including age, gender, race, and geographic regions. Joinpoint regression analysis was utilized to evaluate annual percent changes (APCs) and average annual percent changes (AAPCs). Results Between 2010 and 2020, the age-adjusted mortality rate (AAMR) for heart failure (HHD) and chronic kidney disease (CKD) rose from 15.2 to 18.7 per 100,0000 individuals, reflecting an average annual percentage change (AAPC) of +2.1% (95% CI: 1.8% to 2.4%, p<0.05). Mortality rates exhibited a steady upward trend throughout the study period. The Black/African American demographic faced the heaviest mortality burden, with an AAMR of 38.4 in 2020, in contrast to 14.1 for White individuals and 12.6 for Hispanic individuals. The annual percentage change (APC) for Black/African Americans was +3.5% (95% CI: 2.9% to 4.1%, p<0.05), significantly surpassing that of other racial groups. During the entire period, males exhibited higher death rates than females, with an AAMR of 22.1 for males compared to 15.4 for females in 2020. Both male and female annual percentage changes were significantly increasing, with males showing an APC of +2.4% (95% CI: 2.0% to 2.8%) and females an APC of +1.9% (95% CI: 1.5% to 2.3%). In 2020, mortality rates were greater in rural regions (AAMR: 21.5) than in urban settings (AAMR: 16.3). Rural areas had an APC of +2.8% (95% CI: 2.3% to 3.2%), which was significantly higher than the APC of urban areas (APC: +1.7%, 95% CI: 1.4% to 2.0%). In 2020, the Western U.S. region recorded the lowest AAMR (14.5) and a slower APC of +1.3% (95% CI: 1.0% to 1.6%), while the Southern U.S. exhibited the highest AAMR (20.9) along with an APC of +2.6% (95% CI: 2.1% to 3.0%). Conclusion Mortality from HHD and CKD has significantly increased over the last decade, disproportionately affecting Black and African American groups, men, and those residing in rural and Southern regions.Illustration Table 1