J Hum Hypertens. 2026 Jul 11. doi: 10.1038/s41371-026-01175-0. Online ahead of print.
ABSTRACT
Hypertensive Nephrosclerosis (HSN), a progressive kidney disease, has significantly impacted mortality and morbidity, via cardiovascular events, end-stage renal disease, and infections. Despite its clinical and public health impact, comprehensive analyses of U.S. mortality trends remain understudied. We aim to assess trends in Nephrosclerosis-related deaths in the United States (1999-2020). We extracted HSN-related deaths in older adults aged ≥65 years (1999-2020) using the CDC WONDER database [using ICD-10 code: I-12 (Hypertensive renal disease)]. Crude- and age-adjusted mortality rates (CMR and AAMR) per 100,000 population were determined. We used Joinpoint regression to examine changes in trends and average- and annual percentage change (AAPC and APC) overall and then stratified into demographic and geographical subgroups. A total of 519,817 deaths were recorded due to HSN. Overall, the AAMR rose from 21.51 (1999) to 132.03 (2020) [AAPC, 8.80 (95% CI: 6.53 to 12.08)], especially in age-group 85+ (CMR: 203.36). The overall mortality surged the most remarkably between 2011 and 2014 [APC, 34.74 (95% CI: 1.31 to 50.76)]. Males demonstrated higher AAMRs (67.56) than females (48.93). Racially/ethnically, Non-Hispanic (NH) Blacks (117.99), followed by Hispanics (70.22), exhibited increased vulnerability. Geographically, the Western region (65.71) and rural areas (56.88) held the highest mortality burden. State-wise AAMRs ranged between Connecticut to the District of Columbia (28.58 and 85.8, respectively). In conclusion, HSN-related mortality has increased trends over the last two decades. Males, NH Blacks, 85+ age group, individuals from Western region, and rural residents were the high-risk subgroups. These results call for future research to explore the correlation between observed disparities.
PMID:42436352 | DOI:10.1038/s41371-026-01175-0