Study shows sharp increase in kidney disease deaths linked to high blood pressure

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. The meeting is in Baltimore, September 4-7, 2025, and is the premier scientific exchange focused on recent advances in basic and clinical research on high blood pressure and its relationship to cardiac and kidney disease, stroke, obesity and genetics.

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. Despite national efforts to reduce health inequalities, Black individuals still had over three times the death rate compared to other groups of people."

Joiven Nyongbella, M.D., an M.P.H. candidate and internal medicine resident at Wayne State University/Henry Ford Rochester Hospital in Detroit

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:

• Kidney disease caused by high blood pressure resulted in 274,667 deaths from 1999-2023 among individuals ages 15 and older.
• From 1999-2023, the age-adjusted mortality rate (AAMR) for hypertensive kidney disease deaths rose from 3.3 per 100,000 people in 1999 to 4.91 per 100,000 people in 2023, an increase of 48%.
• Men had a higher average AAMR than women (4.48 vs. 3.69, respectively), with a 22% higher mortality in individuals with renal failure.
• The highest average AAMR was for individuals who were identified as Black, at 10.37 per 100,000 people versus the range of 3.33 - 3.90 per 100,000 for people in other population groups. Hispanic individuals had a 15% higher AAMR when compared to non-Hispanic individuals (4.55 vs. 3.97, respectively).
• Across the U.S., the West had the highest overall AAMR for hypertensive kidney disease deaths at 4.59 per 100,000. In the South, Washington, D.C., (7.6 per 100,000), Tennessee (5.9) and Mississippi (5.83) had the highest AAMRs.

"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.

Study details, background and design:  

• Data from the CDC WONDER database was reviewed for all death certificates in the U.S. from 1999 to 2023 with any of the ICD-10 codes for hypertensive renal disease with and without renal failure listed as a cause of death.
• The analysis included demographic information about people who had died with and without hypertensive renal disease, ages 15 to 85 and older; 54.9% were women, 23.5% were Black, 8.47% were Hispanic and 68% were from other racial and ethnic groups.
• Age-adjusted mortality rates (AAMRs) per 100,000 were calculated and stratified by year, sex, race, ethnicity, state and region.
• The abstract also details the additional calculations used to assess trends including average annual percent change (AAPC) in deaths statistical testing.