This study examines trends in hypertension-related mortality in the U.S. before, during, and after the COVID-19 pandemic, assessing demographic and regional disparities.

We used CDC WONDER’s Provisional Multiple Cause of Death database (2018–2023) to analyze age-adjusted mortality rates (AAMRs) for hypertension (ICD-10: I10–I15). We calculated percentage changes across three periods: pre-COVID (2018–2019), during COVID (2020–2021), and post-COVID (2022–2023), stratifying by age, sex, race/ethnicity, and region.

Hypertension-related AAMRs increased by 33.4 % from pre- to during COVID (193.5–258.2 per 100,000) and remained 28.1 % above pre-pandemic levels post-COVID. Mortality rose across all demographics, with men experiencing a 34.1 % increase and younger adults (25–44 years) experiencing the highest rise (42.1 %). Hispanic individuals saw the largest increase (49.8 %) but also the sharpest post-pandemic decline (17.8 %). Regional disparities persisted, with the South having the highest increase (37.2 %) and the smallest drop (1.5 %).

Despite a modest decline post-pandemic, hypertension-related mortality remains elevated, with persistent disparities by sex, age, race, and region. Targeted interventions are needed to address hypertension management and reduce mortality in high-risk populations.

Hypertension

Mortality

COVID-19

Health disparities

Epidemiology

Racial Inequities

Geographic Variations

Public health

Age-Adjusted Mortality Rates

Cardiovascular disease

© 2025 The Author(s). Published by Elsevier Inc.