Mortality Due to Hypertension-Related Vascular Dementia Rising in the US

Deaths associated with hypertension-related vascular dementia among adults aged 65 and older have steadily increased over the past 2 decades in the United States, according to study results presented at the 2025 American Academy of Neurology (AAN) annual meeting, held from April 5 to 9, 2025, in San Diego, California.

Researchers performed a 15-year demographic trend analysis to determine the impact of hypertension on vascular dementia-related mortality in adults aged 65 and older in the US. They obtained death certificates for this study population from 2005 to 2020 from the Centers for Disease Control and Prevention (CDC) and analyzed the causes of death associated with ICD-10 diagnosis codes for vascular dementia and hypertension.

Between 2005 and 2020, 105,246 deaths related to hypertension-associated vascular dementia occurred in individuals aged 65 and older. The age-adjusted mortality rate per 100,000 persons steadily increased from 7.873 in 2005 to 14.088 in 2015 (annual percent change: 4.3261; 95% CI, 1.1598-6.0203) followed by a sharp increase to 26.246 in 2020 (annual percent change: 11.8793; 95% CI, 8.6939-18.4215).

When analyzing deaths from hypertension-related vascular dementia according to race and ethnicity, Black or African American individuals demonstrated the highest overall age-adjusted mortality rate (33.561) followed by White, (25.921), Hispanic, or Latino individuals (21.744), and, lastly, individuals who were Asian or Pacific Islanders (18.983).

The researchers found that sex differences may influence disease processes as women compared with men, demonstrated higher age-adjusted mortality rates. In 2005, the age-adjusted mortality rate for women was 8.161 vs 7.182 for men. In 2020, the age-adjusted mortality rate among women rose to 26.944 compared to 24.653 in men.

The researchers also analyzed mortality rates associated with hypertension-related vascular dementia according to geographic regions within the US, including Western, Midwestern, Southern, and Northeastern regions and urban vs non-urban areas. They observed that the mortality rate was highest in the Western US (31.157) followed by the Midwest (28.643), South (26.436), and Northeast (17.616). Metropolitan regions demonstrated a slightly higher mortality rate (26.36) compared with non-metropolitan regions (25.718).

“Hypertension-associated vascular dementia mortality rates rose persistently from 2005 to 2020,” the researchers concluded. “Black or African American ethnicity, female gender, and the Western region were associated with greater mortality rates and could be potential risk factors.”