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The death rate from hypertensive kidney disease (high blood pressure-related kidney disease) increased by 48% in the U.S. over the past 25 years, with continued differences across demographic groups, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025.
"This is the first study to examine 25 years of national data on hypertensive kidney disease deaths across all U.S. states and major demographic groups, " said Joiven Nyongbella, M.D., an M.P.H. candidate and internal medicine resident at Wayne State University/Henry Ford Rochester Hospital in Detroit. "Despite national efforts to reduce health inequalities, Black individuals still had over three times the death rate compared to other groups of people."
High blood pressure (when the force of the blood pushing against the walls of vessels is too high) is a known risk factor for kidney damage. It is the second leading cause of end-stage kidney disease and contributes significantly to morbidity and mortality. Untreated high blood pressure can lead to serious outcomes, such as heart attack, stroke, heart failure and progression to kidney failure. Globally, the rate of death from chronic kidney disease increased 24% from 1990 to 2021, according to the American Heart Association's 2025 Heart Disease and Stroke Statistics.
This study, looking at data from 1999—2023, found age-adjusted mortality rate (AAMR) for hypertensive kidney disease deaths increased 48%. Men, people living in the South and Black or Hispanic adults had higher than average death rates.
"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, " said Nyongbella. "The message is simple: check your blood pressure, treat it early and don't ignore it, because it can quietly lead to life-threatening kidney problems."
In this study, researchers reviewed data from the U.S. Centers for Disease Control and Prevention's (CDC's) WONDER database from 1999 to 2023 for all death certificates noted with hypertensive renal disease as the cause of death. The analysis found:
"This study provides important observational data indicating a concerning rise (48%) in age-adjusted deaths due to high blood pressure-related kidney disease over the last 25 years, especially among men, and Black and Hispanic individuals, " said American Heart Association volunteer expert Sidney C. Smith Jr., M.D., FAHA.
"These findings are in line with the recently released 2025 AHA/ACC High Blood Pressure Guideline and AHA's Presidential Advisory on Cardiovascular Kidney Metabolic (CKM) Health. Both papers emphasize the importance of early treatment for high blood pressure, its direct link to kidney disease, as well as the impact of social factors among high-risk populations." Smith is a cardiologist and professor of medicine at the University of North Carolina's School of Medicine, a past president of the American Heart Association and a co-author of the 2025 AHA/ACC High Blood Pressure Guideline; he was not involved in this study.
There are several limitations to the study's findings. Of note, the study relied solely on death certificate data, which may include errors due to missing or mislabeled causes of death. In addition, individual health factors like access to care, medication use or diet were not available, so future research is needed to investigate these factors in addition to health data.
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