Impact of Hypertension on Mortality due to Vascular Dementia: Nationwide Trends from CDC-WONDER (1999–2023)
Waqas Ahmad1, Muhammad Saim1, Hafiz Haseeb Ahsan1, Jamil Numan2, Arbaz Hassan1, Anum Fatima1, Ayesham Zahra1, Roshail Sajjad1, Aiza Shafique1, Atif Malik1, Farah Shehryar3, Faseeh Haider4, Syed Inam5
1Sheikh Zayed Medical College/Hospital, 2Marshall University/ MUSOM, 3Khyber Medical College, 4Allama Iqbal Medical College, 5Louisiana State University School of Medicine New Orleans Neurology
Objective:
To analyze national mortality trends in vascular dementia among U.S. adults aged ≥55 years, comparing outcomes with and without hypertension to assess its impact on mortality patterns.
Background:
Vascular dementia, the second most common dementia subtype, arises from chronic cerebral hypoperfusion. Hypertension accelerates arteriolosclerosis and small vessel disease, leading to cognitive decline. Effective cardiovascular risk management is crucial to reduce the growing burden of vascular dementia.
Design/Methods:
CDC WONDER data (1999–2023) were analyzed for U.S. adults aged ≥55 years with vascular dementia (ICD-10: F01) as the underlying cause of death along with Hypertension (I10–I15) as a multiple cause. Age-adjusted mortality rates (AAMR) were stratified by demographics and region. Joinpoint regression (JPR) estimated Annual Percent Changes (APCs) with p < 0.05 as the threshold for significance.
Results:
From 1999 to 2023, the U.S. recorded 262,788 deaths due to Vascular Dementia (VD) and 58,738 deaths due to VD along with Hypertension (HTN). Higher mortality in females was observed in both conditions (VD: 63.69%, VD+HTN: 66.19%). AAMR in Vascular Dementia rose from 3.9 to 23.5, with APC of -2.83 (95% CI: -6.82 to -0.26) from 1999–2018 and 109.11 (95% CI: 71.30 to 143.50) from 2018–2021. AAMR in VD+ HTN group increased from 0.1 to 6.5 (APC: 125.26). Among Black individuals, AAMR in VD group rose from 1.3 to 23.9 (APC: 59.83; 95% CI: 43.45–342.13). In the South, mortality surged after 2016 in VD+HTN group (APC: 13.84; 95% CI: 8.69–23.2), with persistent regional and racial disparities.
Conclusions:
Mortality rates due to vascular dementia especially with hypertension, has increased in several vulnerable groups such as females, non-Hispanic and Black population. Notable interventions and multidisciplinary approach is required to make significant impact in mortality reduction.
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