Deaths from hypertensive kidney disease — kidney damage caused by high blood pressure — have surged nearly 50% in the United States over the past 25 years, with striking disparities across demographic groups, according to preliminary research presented Thursday at the American Heart Association’s Hypertension Scientific Sessions 2025.
The study, the first to review 25 years of national data on deaths from hypertensive kidney disease, found that Black Americans continued to face disproportionately high mortality rates despite ongoing efforts to address health inequities.
“High blood pressure isn’t just about strokes or heart attacks — it’s also a major cause of kidney disease and death, especially in Black and Hispanic communities,” said lead author Joiven Nyongbella, M.D., an internal medicine resident and M.P.H. candidate at Wayne State University/Henry Ford Rochester Hospital.
Key Findings
Researchers examined U.S. death certificate data from 1999 to 2023, collected through the Centers for Disease Control and Prevention’s WONDER database. Their analysis revealed:
274,667 deaths from hypertensive kidney disease occurred among individuals aged 15 and older.
The age-adjusted mortality rate (AAMR) rose from 3.3 per 100,000 people in 1999 to 4.91 in 2023 — a 48% increase.
Men had higher mortality rates than women (4.48 vs. 3.69 per 100,000).
Black adults had the highest average AAMR, 10.37 per 100,000, more than triple that of other groups (3.33–3.90 per 100,000).
Hispanic individuals had a 15% higher mortality rate than non-Hispanic individuals (4.55 vs. 3.97 per 100,000).
Regionally, the West recorded the highest overall AAMR (4.59 per 100,000), while the District of Columbia (7.6), Tennessee (5.9), and Mississippi (5.83) had the highest state-level rates.
Broader Context
High blood pressure is the second leading cause of end-stage kidney disease and a major contributor to heart attack, stroke, and heart failure. Globally, chronic kidney disease deaths increased by 24% from 1990 to 2021, according to the American Heart Association’s 2025 Heart Disease and Stroke Statistics.
“These findings highlight an urgent need for earlier detection and treatment of high blood pressure, especially in communities disproportionately affected,” said American Heart Association expert Sidney C. Smith Jr., M.D., FAHA, a cardiologist at the University of North Carolina School of Medicine. Smith, who co-authored the 2025 AHA/ACC High Blood Pressure Guideline but was not involved in this study, added that the results align with the AHA’s recent call to address cardiovascular-kidney-metabolic health as an interconnected issue.
Study Limitations
Researchers cautioned that their findings relied exclusively on death certificate data, which may contain inaccuracies. Additionally, the study could not account for individual health factors such as access to medical care, medication adherence, or diet. Future studies, they noted, should integrate broader health and social data to better understand the drivers of these disparities.
The Hypertension Scientific Sessions 2025, held Sept. 4–7 in Baltimore, is the American Heart Association’s flagship meeting on advances in blood pressure, kidney health, stroke, obesity, and genetics.
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