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This study aims to examine trends and disparities in HF\u2010related mortality among hypertensive older adults (\u226565\u00a0years) in the United States from 1999 to 2020. Centers for Disease Control and Prevention\u2014Wide\u2010ranging Online Data for Epidemiologic Research (CDC\u2010WONDER) database data were analyzed, focusing on HTN as the underlying cause and HF as the contributing cause of death. Age\u2010adjusted mortality rates (AAMRs) and crude rates were stratified by gender, race\/ethnicity, age groups, urban\u2013rural status, and geographic regions. The Joinpoint regression program was used to calculate annual percentage changes (APCs) and average annual percentage changes (AAPCs). A total of 259\u00a0079 HF\u2010related deaths occurred among hypertensive older adults, with an overall AAMR increase from 11.27 in 1999 to 41.05 in 2020, indicating a clear upward trend (AAPC: 5.51%). Females had higher AAMRs (28.57) than males (25.56); however, males showed a steeper rise in mortality (AAPC: 6.15% vs. 5.23%). Non\u2010Hispanic Blacks had the highest AAMR (43.99), while NH Whites exhibited the most significant increase (AAPC: 5.92%). Mortality rates were highest in the West (AAMR: 34.57) and lowest in the Northeast (21.44). Non\u2010metropolitan areas had a higher AAMR than metropolitan areas (30.69 vs. 26.52). These findings emphasize the necessity for targeted interventions to diminish disparities and tackle increasing mortality rates in vulnerable populations, especially among women, NH Blacks, individuals in the West, and those living in non\u2010metropolitan areas.<\/jats:p>","DOI":"10.1111\/jch.70064","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T07:52:37Z","timestamp":1746863557000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends and Disparities in Heart Failure Mortality Among Hypertensive Older Adults in the United States: A 22\u2010Year Retrospective Study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1633-3827","authenticated-orcid":false,"given":"Ahmed","family":"Raza","sequence":"first","affiliation":[{"name":"Department of Medicine Services Institute of Medical Sciences Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9836-7228","authenticated-orcid":false,"given":"Manal","family":"Kaleem","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3729-111X","authenticated-orcid":false,"given":"Muhammad Aliyan Ahmed","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Department of Surgery Dr. Ruth KM PFAU Civil Hospital Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-0994","authenticated-orcid":false,"given":"Fatima","family":"Mansoor","sequence":"additional","affiliation":[{"name":"Department of Medicine Karachi Medical and Dental College Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0384-6970","authenticated-orcid":false,"given":"Muhammad","family":"Ansab","sequence":"additional","affiliation":[{"name":"Department of Medicine Services Institute of Medical Sciences Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4261-0638","authenticated-orcid":false,"given":"Mustafa","family":"Turkmani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Michigan State University East Lansing Michigan USA"},{"name":"Department of Internal Medicine McLaren Health Care, Oakland  Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3216-6323","authenticated-orcid":false,"given":"Ubaid","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Maryland School of Medicine Baltimore USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001209"},{"key":"e_1_2_13_3_1","unstructured":"Hypertension accessed November 27 2024 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hypertension."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581\u2010019\u20100244\u20102"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0225207"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMACARDIO.2022.2213"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/AMJ.2020.03.03\/COIF"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/IMJ.15253"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002910"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/NRCARDIO.2016.163"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.HFC.2019.09.001"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.012575"},{"key":"e_1_2_13_13_1","unstructured":"Multiple Cause of Death 1999\u20132020 Request accessed September 10 2024 https:\/\/wonder.cdc.gov\/mcd\u2010icd10.html."},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3121\/CMR.2015.1276"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JCHF.2022.06.012"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"issue":"166","key":"e_1_2_13_17_1","first-page":"1","article-title":"2013 NCHS Urban\u2010Rural Classification Scheme for Counties","author":"Ingram D. 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