Temporal trends in hypertension and pulmonary embolism–related mortality in the United States: A population-based study using CDC WONDER, 2000–2020

Background : Hypertension (HTN) is a major public health concern and a key risk factor for pulmonary embolism (PE), contributing substantially to cardiovascular mortality. Despite treatment advances, trends in related mortality remain underexplored. Objectives : This study examined national trends in HTN and PE-related mortality in the United States from 2000 to 2020 and assessed demographic and geographic disparities. Methods : A retrospective analysis of CDC WONDER data was performed, focusing on HTN (ICD I10-I15) and PE (ICD I26.0, I26.9, I82.8, I82.9). Joinpoint regression estimated age-adjusted mortality rates (AAMR) per 100,000 and annual percentage changes (APC). Data were stratified by year, sex, race/ethnicity, age, census region, urbanization, and state. Results : From 2000–2020, 92,181 HTN and PE-related deaths were recorded. AAMR rose from 1.3 to 3.6, with an average annual percent change (AAPC) of 4.5% (p < 0.001). Men consistently had higher mortality (1.4 vs. 1.2 in 2000; 3.9 vs. 3.2 in 2020). NH Black patients had the highest AAMR (4.6), while NH White patients showed the steepest rise (AAPC: 5.0, p < 0.001). Older adults had the highest AAMR (7.5), but younger adults showed the sharpest increase (AAPC: 6.0%, p < 0.001). The South had the highest AAMR (2.2), while the Midwest had the fastest growth (AAPC: 5.1%, p < 0.001). State-level AAMRs in 2020 ranged from 0.9 (Maine) to 5.5 (District of Columbia). Conclusion : HTN and PE-related mortality has risen markedly with disparities across age, sex, race, and geography, highlighting the need for equity-focused interventions.