Trends and Disparities in Chronic Kidney Disease and Hypertension-Related Mortality in the United States, 2000–2023

Background Chronic kidney disease (CKD) and hypertension (HTN) are closely linked, often coexisting to increase cardiovascular risk and mortality. Despite their growing burden, long-term national mortality patterns remain insufficiently characterized. Objective Our objective is to evaluate temporal trends and disparities in CKD and HTN-related mortality in the United States from 2000 to 2023. Methods We obtained mortality data from the CDC WONDER Multiple Cause-of-Death database using ICD-10 codes for CKD and HTN. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated by sex, race/ethnicity, and state. Joinpoint regression identified inflection points and annual percent change (APC) in mortality. Results Between 2000 and 2023, 1,618,000 CKD and HTN-related deaths were recorded in the United States. Overall AAMRs increased from 4.3 to 7.3 per 100,000, with four distinct phases: decline (2000–2005), plateau (2005–2012), sharp rise (2012–2019), and continued escalation during the COVID-19 era (2019–2023). Men consistently had higher AAMRs than women, and non-Hispanic Black individuals showed the greatest racial disparities. Geographic variation was marked, with Southern states recording the highest rates, while states such as Mississippi and Louisiana reported mortality more than double that of Colorado and Massachusetts. Conclusion CKD and HTN-related mortality in the U.S. has risen substantially since 2012, with widening sex, racial, and geographic disparities. Targeted prevention, equitable access to CKD and blood pressure management, and improved health system resilience are urgently needed.