Hypertensive Kidney Disease Deaths Surge 48% Over 25 Years, Revealing Stark Racial and Regional Disparities

Death rates from hypertensive kidney disease have increased by 48% in the United States over the past 25 years, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025. The study analyzed data from the U.S. Centers for Disease Control and Prevention's WONDER database from 1999 to 2023, revealing persistent disparities across racial, ethnic, gender and geographic lines.

The research found that kidney disease caused by high blood pressure resulted in 274,667 deaths from 1999-2023 among individuals ages 15 and older. The age-adjusted mortality rate rose from 3.3 per 100,000 people in 1999 to 4.91 per 100,000 people in 2023. High blood pressure is the second leading cause of end-stage kidney disease and contributes significantly to morbidity and mortality, with untreated hypertension potentially leading to serious outcomes including heart attack, stroke, heart failure and progression to kidney failure.

The most alarming findings concern racial disparities. Black individuals had the highest average age-adjusted mortality rate at 10.37 per 100,000 people, more than three times the rates observed in other population groups, which ranged from 3.33 to 3.90 per 100,000. Hispanic individuals had a 15% higher mortality rate compared to non-Hispanic individuals (4.55 vs. 3.97, respectively). These findings persist despite national efforts to reduce health inequalities.

Gender and regional disparities were also evident. Men had a higher average mortality rate than women (4.48 vs. 3.69, respectively), with a 22% higher mortality in individuals with renal failure. Geographically, the West had the highest overall mortality rate at 4.59 per 100,000, while the South showed particularly high rates in specific areas. Washington, D.C. (7.6 per 100,000), Tennessee (5.9) and Mississippi (5.83) had the highest mortality rates among southern states.

The study's findings align with the recently released 2025 AHA/ACC High Blood Pressure Guideline and the American Heart Association's Presidential Advisory on Cardiovascular Kidney Metabolic Health. Both documents emphasize the importance of early treatment for high blood pressure, its direct link to kidney disease, and the impact of social factors among high-risk populations. The research underscores that hypertension isn't just about strokes or heart attacks but is also a major cause of kidney disease and death, particularly in Black and Hispanic communities.

This analysis provides crucial observational data indicating a concerning rise in age-adjusted deaths due to high blood pressure-related kidney disease over the last quarter-century. The findings highlight the urgent need for improved screening and management of hypertension to reduce the risk of hypertensive kidney disease, especially in communities at higher risk. The study represents the first comprehensive examination of 25 years of national data on hypertensive kidney disease deaths across all U.S. states and major demographic groups, providing valuable insights for public health officials and healthcare providers working to address these disparities.