Evidence map›Paper›PMID 40686020›Full record

ArticleBrain and behavior2025

Trends and Disparities in Hemorrhagic Stroke and Hypertension-Related Mortality in the United States From 1999 to 2023: A CDC WONDER Database Analysis.

Muhammed Ameen Noushad, Emer Mulholland, Jaisurya Jaisukhalal, Reem Abukhater, Wahhaj Qayyum, Munikaverappa Anjanappa Mukesh, Jovita Jerome D Silva, Mubashir Tanvir Sheikh, Muhammad Muneeb Arshad, Naweed Ebrahim Essa and 3 more

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Article in Brain and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Muhammed Ameen NoushadUniversity Hospital Plymouth NHS Trust, Plymouth, UK.
Emer MulhollandUniversity Hospital Plymouth NHS Trust, Plymouth, UK.
Jaisurya JaisukhalalUniversity Hospital Plymouth NHS Trust, Plymouth, UK.ORCID https://orcid.org/0000-0003-4838-7884
Reem AbukhaterRAK Medical and Health Sciences University, Ras Al-Khaimah, UAE.
Wahhaj QayyumSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Munikaverappa Anjanappa MukeshSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Jovita Jerome D SilvaUniversity Hospital Plymouth NHS Trust, Plymouth, UK.
Mubashir Tanvir SheikhGastroenterology, Cumberland Infirmary, Carlisle, UK.
Muhammad Muneeb ArshadUniversity Hospital Birmingham, NHS Foundation Trust, Birmingham, UK.
Naweed Ebrahim EssaUniversity Hospital Plymouth NHS Trust, Plymouth, UK.
Eeshal ZulfiqarDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Mushood AhmedDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Raheel AhmedNational Heart & Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0000-0001-9872-8224

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHemorrhagic stroke remains a major cause of mortality, with hypertension being a key modifiable risk factor. Despite advancements in management, demographic and geographic disparities persist. This study aims to analyze hemorrhagic stroke-related mortality trends among hypertensive adults in the United States from 1999 to 2023, stratified by sex, race, and geographic location.

methodsWe utilized death certificate data from the CDC WONDER database for individuals aged ≥ 25 years from 1999 to 2023. Crude mortality rates (CMR) and Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and annual percentage change (APC) were determined using Joinpoint regression analysis.

resultsFrom 1999 to 2023, a total of 372,922 deaths were identified related to hemorrhagic stroke and hypertension. The overall AAMR was 0.45 in 1999 and 6.88 in 2023, with no significant trend observed over the study period. Males consistently exhibited higher AAMRs than females (Males: 7.76 vs. Females: 6.06 in 2023). When stratified by race, the highest AAMR was observed in non-Hispanic (NH) Black or African American populations, followed by NH other, Hispanic or Latino, and NH White populations (AAMR of 10.95, 8.20, 7.83, and 5.86, respectively, in 2023). Regionally, the highest mortality was observed in the West, followed by the South, the Midwest, and lastly, the Northeast (with values of 7.91, 7.76, 5.91, and 4.82, respectively, in 2023). Urban areas (6.79) exhibited consistently higher AAMRs than rural areas (6.13) from 1999 to 2020.

conclusionHemorrhagic stroke and hypertension-related mortality remained stable in the United States from 1999 to 2023, with males, NH Black or African American populations, and the Western region exhibiting the highest AAMRs. These findings highlight the importance of improving hypertension management and addressing mortality disparities.

Indexed as

Hemorrhagic StrokeHypertensionStrokeAdultAgedAged, 80 and overBlack or African AmericanCenters for Disease Control and Prevention, U.S.Databases, FactualFemaleHealth Status DisparitiesHumansMaleMiddle AgedMortalityRisk FactorsCDC WONDERhypertensionmortalitystroke

Identifiers

PMID40686020
PMCPMC12277664

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.