Abstract
Introduction: Falls are a leading cause of death in older adults, with hypertension (HTN) potentially increasing this risk. However, trends in fall-related mortality with co-existing HTN remain understudied. We hypothesize an increasing trend in fall-related mortality among older adults with HTN, with disparities by sex, region, and place of death.
Methods: A retrospective analysis of adults ≥65 years was conducted using CDC WONDER (1999–2023). Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, region, and place of death. Trends were assessed using annual and average percentage change (APC & AAPC).
Results: From 1999 to 2023, 215,214 fall-related deaths with co-existing hypertension were recorded, showing a significant increasing mortality trend (p < 0.000001). Males had higher mortality than females (20.39 vs. 17.13 per 100,000), with significant AAPCs of 11.24% and 10.57%, respectively. In males, AAMRs rose from 2.93 in 1999 to 42.59 in 2023, with sharp increases from 1999–2001 (APC: 45.19%) and 2018–2021 (APC: 13.56%). Females showed a similar trend, rising from 2.87 to 35.57, with notable spikes in the same periods (APC: 42.44% and 13.43%). Most deaths occurred in medical facilities (52.84%), followed by nursing homes (19.09%), hospices (12.99%), and homes (10.86%). Regionally, the Midwest had the highest AAMR (22.88), followed by the West (18.58), South (18.15), and Northeast (14.11), with corresponding AAPCs of 10.81%, 8.68%, 11.45%, and 10.86%.
Conclusion: Mortality rates among older adults has risen significantly over the past two decades, with consistently higher rates in males and marked regional disparities. The predominance of deaths in medical and long-term care facilities underscores the need for enhanced fall-prevention strategies in these settings. Targeted interventions, particularly in high-burden regions like the Midwest and sex-specific approaches are essential to mitigate this growing public health concern.