Death rates from hypertensive kidney disease have increased by 48% in the United States over the past 25 years, with persistent and concerning disparities across racial, ethnic, gender and geographic lines according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025. The analysis of CDC WONDER database data from 1999-2023 reveals that 274,667 deaths occurred among individuals aged 15 and older due to kidney disease caused by high blood pressure during this period.
The age-adjusted mortality rate rose from 3.3 per 100,000 people in 1999 to 4.91 per 100,000 in 2023, representing a nearly 50% increase. The most alarming finding shows Black individuals experienced death rates over three times higher than other population groups, with an average rate of 10.37 per 100,000 compared to 3.33-3.90 for other groups. Hispanic individuals also faced disproportionately high rates, showing a 15% higher mortality rate compared to non-Hispanic individuals.
Men demonstrated higher mortality rates than women (4.48 vs. 3.69 per 100,000), with a 22% higher mortality in individuals with renal failure. Geographically, the South region showed particularly high death rates, with Washington, D.C. (7.6 per 100,000), Tennessee (5.9) and Mississippi (5.83) recording the highest age-adjusted mortality rates. The West region had the highest overall regional rate at 4.59 per 100,000.
High blood pressure remains the second leading cause of end-stage kidney disease and significantly contributes to morbidity and mortality. Untreated hypertension can lead to serious outcomes including heart attack, stroke, heart failure and progression to kidney failure. These findings align with the recently released 2025 AHA/ACC High Blood Pressure Guideline and the AHA's Presidential Advisory on Cardiovascular Kidney Metabolic Health, both emphasizing the importance of early treatment for high blood pressure and its direct link to kidney disease.
The study's lead researcher, Dr. Joiven Nyongbella, emphasized that "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." The research underscores the urgent need for improved screening and management of high blood pressure to reduce hypertensive kidney disease risk, particularly in higher-risk communities. American Heart Association volunteer expert Dr. Sidney C. Smith Jr. noted these findings highlight the impact of social factors among high-risk populations and the critical importance of addressing health disparities.
Study limitations include reliance on death certificate data, which may include errors due to missing or mislabeled causes of death, and the absence of individual health factors such as access to care, medication use or dietary information. The research was presented as an abstract at the American Heart Association's scientific meeting and has not yet undergone peer review for publication in a scientific journal.
