{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:51:32Z","timestamp":1791809492082,"version":"4.3.4"},"reference-count":60,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertension (HTN) is a major modifiable risk factor associated with cognitive decline including Alzheimer's disease (AD), which continues to be the leading cause of dementia and death in the United States (U.S.). However, the national mortality burden of coexisting AD and HTN across demographic and geographic groups remains poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to study these trends to provide insights for better prevention, management, and policy planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted using the CDC WONDER Multiple Cause-of-Death database (1999\u20132023), focusing on adults aged \u226565 years with AD and HTN. Temporal trends were assessed using Joinpoint regression to estimate annual percent changes. Mortality patterns were examined by sex, race, region, urban-rural status, state, and place of death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 1999 and 2023, 504,360 deaths among U.S. adults aged \u226565 years listed both AD and HTN on death certificates, with age-adjusted mortality rates rising from 14.5 to 60.0 per 100,000. Women consistently experienced higher mortality than men (67.5 versus 48.1 per 100,000 in 2023). Non-Hispanic African American adults had the greatest overall burden (57.1) among races. Geographically, mortality was highest in non-metropolitan areas (48.7) and the West region (52.6), More than half of all deaths occurred in nursing homes or long-term care facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mortality for coexisting AD and HTN has quadrupled in the U.S. over the past two decades with substantial variations across groups, highlighting the substantial burden of deaths where AD and HTN coexist and the importance of effective HTN control and dementia care across the lifespan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261461304","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T13:51:00Z","timestamp":1782827460000},"page":"1791-1801","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["National trends and disparities in mortality among U.S. older adults, with coexisting Alzheimer's disease and hypertension, 1999-2023"],"prefix":"10.1177","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8157-1037","authenticated-orcid":false,"given":"Muhammad Ibrahim","family":"Rashid","sequence":"first","affiliation":[{"name":"Department of Medicine, Bahria University College of Medicine"},{"name":"Bahria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7240-0214","authenticated-orcid":false,"given":"Muhammad","family":"Abbas","sequence":"additional","affiliation":[{"name":"Ayub Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1883-8149","authenticated-orcid":false,"given":"Ramesha","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bahria University College of Medicine"},{"name":"Bahria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1214-4258","authenticated-orcid":false,"given":"Taha","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5376-2437","authenticated-orcid":false,"given":"Aliya","family":"Noor","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Edward Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1209-7645","authenticated-orcid":false,"given":"Zaigham","family":"Ishrat","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nishtar Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5351-4365","authenticated-orcid":false,"given":"Muhammad","family":"Mudasir","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9887-2893","authenticated-orcid":false,"given":"Muhammad","family":"Ahsan Sarfraz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Shihezi Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0427-9059","authenticated-orcid":false,"given":"Umair","family":"Mehboob","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Edward Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8896-9463","authenticated-orcid":false,"given":"Iman","family":"Osman Abufatima","sequence":"additional","affiliation":[{"name":"University of Medical Sciences and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00438-022-01949-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008731"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31820a55f5"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13809"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/5584_2016_98"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S400527"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7120a2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13717"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21442"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-022-01209-1"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0031-0808.18.03360-8"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2017.1333599"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000211175"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcrp.2025.200390"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.70167"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2025.05.010"},{"key":"e_1_3_3_18_2","unstructured":"Office of Management and Budget. Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. https:\/\/www.govinfo.gov\/content\/pkg\/FR-1997-10-30\/pdf\/97-28653.pdf (1997 accessed 15 May 2026)."},{"key":"e_1_3_3_19_2","first-page":"1","article-title":"2013 NCHS urban-rural classification scheme for counties","volume":"166","author":"Ingram DD","year":"2014","unstructured":"Ingram DD, Franco SJ. 2013 NCHS urban-rural classification scheme for counties. Vital Health Stat 2 2014; 166: 1\u201373.","journal-title":"Vital Health Stat 2"},{"key":"e_1_3_3_20_2","unstructured":"United States Census Bureau. Geography Program Glossary. Census.gov https:\/\/www.census.gov\/programs-surveys\/geography\/about\/glossary.html (accessed 15 May 2026)."},{"key":"e_1_3_3_21_2","first-page":"1","article-title":"Age standardization of death rates: implementation of the year 2000 standard","volume":"47","author":"Anderson RN","year":"1998","unstructured":"Anderson RN, Rosenberg HM. Age standardization of death rates: implementation of the year 2000 standard. Natl Vital Stat Rep 1998; 47: 1\u201316, 20.","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_3_3_22_2","unstructured":"Joinpoint Regression Program. https:\/\/surveillance.cancer.gov\/joinpoint\/index.html (accessed 15 May 2026)."},{"key":"e_1_3_3_23_2","first-page":"1","article-title":"Hypertension-related mortality in the United States, 2000-2013","volume":"193","author":"Kung H-C","year":"2015","unstructured":"Kung H-C, Xu J. Hypertension-related mortality in the United States, 2000-2013. NCHS Data Brief 2015; 193: 1\u20138.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_3_24_2","article-title":"Trends and patterns in hypertension-related deaths: a comprehensive analysis using center for disease control and prevention\u2019s wide-ranging online data for epidemiologic research (CDC WONDER) data","volume":"16","author":"Fasehun OO","year":"2024","unstructured":"Fasehun OO, Adjei-Mensah J, Ugorji WS, et al. Trends and patterns in hypertension-related deaths: a comprehensive analysis using center for disease control and prevention\u2019s wide-ranging online data for epidemiologic research (CDC WONDER) data. Cureus 2024; 16: e70754.","journal-title":"Cureus"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43044-025-00622-6"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e3181902c3e"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.2174\/0115672050338833240924113200"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahjo.2025.100618"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13016"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2022.06.012"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.11.044"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2020.00005"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828726f5"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb03842.x"},{"key":"e_1_3_3_35_2","unstructured":"Death certificates may not adequately report dementia as cause of death. National Institute on Aging https:\/\/www.nia.nih.gov\/news\/death-certificates-may-not-adequately-report-dementia-cause-death (2020 accessed 15 May 2026)."},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.650"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40292-015-0108-1"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12707"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.336869"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13374"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-190474"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)03086-4"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1069"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-022-01221-5"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002660"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvae010"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40885-023-00237-6"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-018-1920-1"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-180141"},{"key":"e_1_3_3_50_2","unstructured":"Murphy SL Kochanek KD Xu J et al. Mortality in the United States 2023. Hyattsville MD: National Center Health Statistics (U.S.). NCHS Data Brief No. 521 December 2024. https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db521.htm."},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004602"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gln016"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2024.01.024"},{"key":"e_1_3_3_54_2","first-page":"1","article-title":"Hypertension prevalence and control among adults: United States, 2011-2014","volume":"220","author":"Yoon SSS","year":"2015","unstructured":"Yoon SSS, Carroll MD, Fryar CD. Hypertension prevalence and control among adults: United States, 2011-2014. NCHS Data Brief 2015; 220: 1\u20138.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17570"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1L368"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13756"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-025-04909-z"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2022.108208"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-018-0334-0"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000240"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261461304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877261461304","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261461304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:41:51Z","timestamp":1791808911000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877261461304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":60,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/13872877261461304"],"URL":"https:\/\/doi.org\/10.1177\/13872877261461304","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}