Abstract Details

Title Temporal Trends in Hypertensive Subarachnoid Hemorrhage Mortality in the United States, 1999-2023: A Population-based Joinpoint Regression Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-013

Objective To analyze temporal trends in SAH-related mortality among hypertensive patients in the U.S. from 1999–2023 using Joinpoint regression.

Background Subarachnoid hemorrhage (SAH) secondary to hypertension remains a major cerebrovascular cause of death. Despite advances in hypertension control and neurosurgical care, mortality patterns across demographic subgroups remain underexplored.

Design/Methods Mortality data were obtained from the CDC WONDER database using ICD-10 codes I60 (subarachnoid hemorrhage) and I10–I15 (hypertensive diseases). Age-adjusted mortality rates (AAMR) per 100,000 population were analyzed by sex, race, census region, and urbanization level, and crude rates (CR) by age group. Trends were assessed using Joinpoint regression to estimate the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) with 95% confidence intervals (CIs).

Results From 1999–2023, 40,198 deaths were attributed to hypertensive SAH. Overall AAMR (0.725) increased significantly (AAPC = 0.97%, p = 0.031). Females had higher AAMR (0.80) than males (0.62), but mortality rose only among males (AAPC = 1.91%, p < 0.001). Asian/Pacific Islanders had the highest AAMR (1.27) yet showed a decline (AAPC = −1.33%, p < 0.001); rates were stable among Black individuals, while White populations showed an increase (AAPC = 1.37%, p < 0.001). Regional variation was evident (West 0.90, South 0.72, Midwest 0.65, Northeast 0.63), with rising mortality in the South (AAPC = 1.64%, p = 0.001) and West (AAPC = 1.07%, p = 0.018). Rural areas showed increasing mortality (AAPC = 2.02%, p = 0.012) despite slightly lower AAMR (0.66) than urban areas (0.71). The steepest increases occurred among ages 75–84 (AAPC = 6.52%, p = 0.004) and 85+ (AAPC = 5.43%, p < 0.001). Columbia showed persistently high but stable rates, whereas Nevada exhibited the sharpest recent rise.

Conclusions Mortality from hypertensive SAH is rising, especially among males, elderly adults, Whites, and rural populations, highlighting disparities in hypertension control and cerebrovascular care.

Authors/Disclosures
Muhammad Moiz Javed, MD PRESENTER	Dr. Javed has nothing to disclose.
Ammad Abid, MBBS	Dr. ABID has nothing to disclose.
Arham K. Farooq, Sr., MBBS	Dr. Farooq has nothing to disclose.
Annas Mehzam, MBBS	Dr. Mehzam has nothing to disclose.
Muhammad Usman Iqbal, MBBS	Mr. Iqbal has nothing to disclose.
Muhammad Nabeel Saddique, MBBS	Mr. Saddique has nothing to disclose.
Asim Abdullah	Mr. Abdullah has nothing to disclose.

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