Hypertensive Kidney Disease Death Rate Up 48% in Past 25 Years

The death rate from hypertensive kidney disease in the US has increased by 48% since 1999, according to findings from a recent analysis of US Centers for Disease Control and Prevention - Wide-Ranging Online Data for Epidemiology Research (CDC WONDER) data.1

In addition to the stark increase in high blood pressure-related renal disease mortality over the past 25 years, study findings highlight disproportionate impacts on African American and Hispanic males, underscoring the need for equitable interventions and efforts to address structural barriers in order to reduce disparities and improve outcomes.1

“This is the first study to examine 25 years of national data on hypertensive kidney disease deaths across all U.S. states and major demographic groups,” Joiven Nyongbella, MD, an internal medicine resident at Wayne State University/Henry Ford Rochester Hospital, said in a statement.2 “Despite national efforts to reduce health inequalities, Black individuals still had over three times the death rate compared to other groups of people.”

Hypertension is a major risk factor for end-organ damage, including kidney damage. According to the National Kidney Foundation, it is the second leading cause of end-stage renal disease after diabetes and contributes significantly to both morbidity and mortality.3

“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 Nyongbella.2 “The message is simple: check your blood pressure, treat it early and don’t ignore it, because it can quietly lead to life-threatening kidney problems.”

To better understand mortality trends and disparities in hypertensive renal disease, he and a team of investigators analyzed death data from the CDC WONDER database from 1999 to 2023 using ICD-10 codes for hypertensive renal disease with and without renal failure. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated and stratified by year, sex, race, ethnicity, and region.1

Results showed that from 1999 to 2023, hypertensive renal disease caused 274,667 deaths among individuals ≥ 15 years of age, with AAMR increasing from 3.3 to 4.91 (average annual percent change [AAPC], 1.51%; 95% CI, 0.53–2.50; P = .0023).1

Upon analysis, men had a greater mean AAMR than women (4.48 vs 3.69; P <.001), with a 22% increased mortality in cases with renal failure (P <.0001) but no significant sex differences observed in cases without renal failure (P = .36).1

Investigators called attention to significant differences across racial groups, with Black individuals having the highest mean AAMR (10.37) versus 3.33-3.90 in other groups. Of note, this disparity remained consistent regardless of renal failure status. Additionally, Hispanic individuals had a 15% higher AAMR when compared to non-Hispanic individuals (4.55 vs 3.97; P <.001).1

Regionally, the West had the greatest overall AAMR (4.59), but the 3 states with the highest rates were in the South: Washington DC (7.6), Tennessee (5.9), and Mississippi (5.83).1

“This study provides important observational data indicating a concerning rise (48%) in age-adjusted deaths due to high blood pressure-related kidney disease over the last 25 years, especially among men, and Black and Hispanic individuals,” said Sidney Smith Jr, MD, a cardiologist and professor of medicine at the University of North Carolina’s School of Medicine.2 “These findings are in line with the recently released 2025 AHA/ACC High Blood Pressure Guideline and AHA’s Presidential Advisory on Cardiovascular Kidney Metabolic (CKM) Health. Both papers emphasize the importance of early treatment for high blood pressure, its direct link to kidney disease, as well as the impact of social factors among high-risk populations.”

References

1. Nyongbella J, Pineiro De Jesus P, Lavu V, et al. Hypertensive Renal Disease Mortality in the United States (1999–2023): A 25- Year Analysis of Trends and Sociodemographic Disparities. Hypertension.
2. American Heart Association. Deaths from high blood pressure-related kidney disease up nearly 50% in the past 25 years. EurekAlert! September 4, 2025. Accessed September 4, 2025. https://www.eurekalert.org/news-releases/1096246?
3. National Kidney Foundation. High Blood Pressure and Chronic Kidney Disease. Accessed September 4, 2025. https://www.kidney.org/high-blood-pressure-and-chronic-kidney-disease