Death rates from hypertensive kidney disease have increased by 48% in the United States over the past 25 years, with persistent disparities across racial, ethnic, gender, and geographic lines, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025. The study, which analyzed data from the CDC WONDER database from 1999 to 2023, found that Black individuals had the highest mortality rates at 10.37 per 100,000 people—more than three times the rates observed in other racial groups.
Hypertensive kidney disease, caused by high blood pressure damaging the kidneys, resulted in 274,667 deaths among individuals aged 15 and older during the study period. The age-adjusted mortality rate rose from 3.3 per 100,000 people in 1999 to 4.91 per 100,000 in 2023. Men had a higher average mortality rate than women (4.48 vs. 3.69 per 100,000), and Hispanic individuals experienced a 15% higher rate compared to non-Hispanic individuals (4.55 vs. 3.97 per 100,000).
Geographically, the South had the highest death rates, with Washington, D.C. (7.6 per 100,000), Tennessee (5.9), and Mississippi (5.83) leading among states. The West region had the highest overall rate at 4.59 per 100,000. These findings underscore the urgent need for enhanced screening and management of high blood pressure, particularly in high-risk communities. High blood pressure is the second leading cause of end-stage kidney disease and contributes significantly to morbidity and mortality, including heart attacks, strokes, and heart failure.
Dr. Joiven Nyongbella, the study's lead author, emphasized that "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." The research aligns with the recently released 2025 AHA/ACC High Blood Pressure Guideline, which stresses early treatment and the impact of social factors on health outcomes. The study's limitations include reliance on death certificate data, which may contain errors, and the absence of individual health factors like access to care or medication use.
This rise in hypertensive kidney disease deaths reflects broader global trends; chronic kidney disease mortality increased 24% from 1990 to 2021, according to the American Heart Association's 2025 Heart Disease and Stroke Statistics. The findings highlight critical health inequities and the necessity for targeted public health interventions to address hypertension management and reduce kidney disease-related mortality.
