National Patterns of Pulmonary Hypertension Mortality in the United States, 2010 to 2024

Central Illustration

Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder associated with substantial morbidity and mortality, affecting an estimated 1% to 2% of U.S. adults and up to 10% of those over age 65, particularly individuals with cardiopulmonary disease. Although outcomes in pulmonary arterial hypertension (PAH/Group 1 PH) have improved with earlier diagnosis and targeted therapies, secondary PH (Groups 2 to 5) accounts for most cases and remains associated with high mortality and limited treatment options. Despite prior reports of increasing PH-related mortality, contemporary trends and demographic disparities by PH subgroup following the 2018 diagnostic threshold revision and the COVID-19 pandemic remain incompletely defined. ,

We used the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database to evaluate PH-related mortality among U.S. adults from 2010 to 2024. Deaths were identified when PH was listed as an underlying or contributing cause (ICD-10 codes I27.0, I27.2, I27.8, I27.9). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population, and temporal trends were assessed using Joinpoint regression to estimate annual and average annual percent change (APC, AAPC).

From 2010 to 2024, a total of 428,810 PH-related deaths occurred in the United States. Overall PH mortality increased steadily from an AAMR of 8.08 per 100,000 in 2010 to 11.13 in 2024, corresponding to an AAPC of 2.38% ( p <0.001) ( Figure 1 and Table 1 ). Mortality rose significantly from 2010 to 2018 (APC 1.78%, p <0.001), followed by a sharper increase from 2018 to 2021 (APC 7.13%, p = 0.036). From 2021 to 2024, mortality stabilized (APC −0.61%, p = 0.65), although rates remained substantially elevated compared with prepandemic levels. Sex-stratified analyses demonstrated consistently higher AAMRs among females than males throughout the study period, with female mortality increasing from 8.55 to 11.80 (AAPC 2.40%, p <0.001) and male mortality from 7.46 to 10.19 (AAPC 2.30%, p = 0.005).

Figure 1

Trends (2010 to 2024) in age-adjusted PH-related mortality rates per 100,000 in the United States overall and stratified by sex and PH-associated comorbidities (A), Group 1 PH by sex (B), Groups 2 to 5 PH by sex (C), Group 1 PH by race/ethnicity (D), Groups 2 to 5 PH by race/ethnicity (E), and proportionate mortality of Group 1 PH and Groups 2 to 5 PH as a percentage of cardiovascular disease deaths (F).

* Indicates APC significantly different from 0 (α=0.05).

AAMRs for Group 1 PH were unavailable for non-Hispanic Asian American/Pacific Islander and non-Hispanic American Indian/Alaska Native populations because of small death counts.

Table 1

Trends in pulmonary hypertension-related mortality in the United States, overall and by PH subgroup, sex, race/ethnicity, and proportionate mortality, 2010 to 2024

Category AAMR 2010 (95% CI) AAMR 2024 (95% CI) AAPC (95% CI); p value Number of joinpoints Period 1 [y]; APC (95% CI); p value Period 2 [y]; APC (95% CI); p value Period 3 [y]; APC (95% CI); p value
Overall PH 8.08 (7.97 to 8.19) 11.13 (11.01 to 11.24) 2.38 (1.08 to 3.69), p <0.001 2 [2010 to 2018] 1.78 (1.12 to 2.44), p <0.001 [2018 to 2021] 7.13 (0.61 to 14.06), p = 0.036 [2021 to 2024] −0.61 (−3.61 to 2.48), p = 0.65
Sex
Female 8.55 (8.40 to 8.70) 11.80 (11.64 to 11.95) 2.40 (1.28 to 3.53), p <0.001 2 [2010 to 2018] 1.74 (0.91 to 2.59), p <0.001 [2018 to 2021] 6.84 (1.20 to 12.79), p = 0.024 [2021 to 2024] −0.13 (−2.71 to 2.51), p = 0.91
Male 7.46 (7.30 to 7.63) 10.19 (10.02 to 10.35) 2.30 (0.71 to 3.92), p = 0.005 2 [2010 to 2018] 1.75 (0.91 to 2.59), p = 0.002 [2018 to 2021] 7.59 (−0.34 to 16.15), p = 0.058 [2021 to 2024] −1.32 (−5.01 to 2.52), p = 0.44
Overall group 1 PH 0.15 (0.13 to 0.17) 0.08 (0.07 to 0.09) −4.70 (−7.12 to −2.22), p = 0.002 2 [2010 to 2013] −7.03 (−14.60 to 1.21), p = 0.082 [2013 to 2017] 6.97 (−1.42 to 16.07), p = 0.092 [2017 to 2024] −9.84 (−11.52 to −8.14), p <0.001
Sex
Female 0.20 (0.17 to 0.22) 0.09 (0.07 to 0.10) −5.29 (−5.96 to −4.61), p <0.001 1 [2010 to 2024] −11.14 (−12.43 to −9.84), p <0.001 — —
Male 0.08 (0.06 to 0.10) 0.07 (0.06 to 0.09) −3.29 (−5.00 to −1.56), p = 0.002 1 [2010 to 2017] 3.48 (0.56 to 6.47), p = 0.020 [2017 to 2024] −9.62 (−12.17 to −7.00), p <0.001 —
Overall group 2 to 5 PH 7.92 (7.81 to 8.03) 11.00 (10.89 to 11.12) 2.44 (1.18 to 3.71), p <0.001 2 [2010 to 2018] 1.79 (1.16 to 2.42), p <0.001 [2018 to 2021] 7.38 (1.04 to 14.11), p = 0.028 [2021 to 2024] −0.60 (−3.49 to 2.71), p = 0.640
Sex
Female 8.36 (8.21 to 8.51) 11.71 (11.55 to 11.87) 2.51 (1.34 to 3.69), p <0.001 2 [2010 to 2018] 1.79 (1.23 to 2.36), p <0.001 [2018 to 2021] 7.09 (1.18 to 13.34), p = 0.025 [2021 to 2024] −0.02 (−2.68 to 2.71), p = 0.990
Male 7.37 (7.20 to 7.53) 10.11 (9.94 to 10.28) 2.34 (0.85 to 3.86), p = 0.002 2 [2010 to 2018] 1.71 (0.93 to 2.51), p = 0.001 [2018 to 2021] 7.88 (0.44 to 15.87), p = 0.040 [2021 to 2024] −1.30 (−4.77 to 2.29), p = 0.410
PH Comorbidities
Group 2 PH Associated Comorbidities 4.22 (4.14 to 4.30) 7.28 (7.18 to 7.37) 4.07 (2.62 to 5.53), p <0.001 2 [2010 to 2018] 3.59 (2.66 to 4.52), p <0.001 [2018 to 2021] 9.50 (2.54 to 16.93), p = 0.014 [2021 to 2024] 0.13 (−3.42 to 3.82), p = 0.930
Group 3 PH Associated Comorbidities 3.41 (3.34 to 3.48) 4.28 (4.21 to 4.35) 1.95 (0.90 to 3.01), p <0.001 1 [2010 to 2014] −0.54 (−3.89 to 2.92), p = 0.730 [2014 to 2024] 2.96 (2.01 to 3.92), p <0.001 —
Group 1 PH Race/Ethnicity
Non-Hispanic White 0.18 (0.16 to 0.20) 0.09 (0.07 to 0.10) −5.41 (−8.43 to −2.29), p <0.001 2 [2010 to 2012] −17.60 (−35.07 to 4.57), p = 0.096 [2012 to 2017] 5.12 (0.23 to 10.25), p = 0.042 [2017 to 2024] −8.75 (−10.44 to −7.03), p <0.001
Non-Hispanic Black 0.13 (0.09 to 0.19) 0.12 (0.09 to 0.17) −2.45 (−4.42 to −0.43), p = 0.018 1 [2010 to 2017] 5.96 (2.54 to 9.50), p = 0.003 [2017 to 2024] −10.19 (−13.09 to −7.19), p <0.001 —
Non-Hispanic Asian or Pacific Islander — — — — — — —
Non-Hispanic American Indian or Alaska Native — — — — — — —
Hispanic/Latino 0.08 (0.04 to 0.14) 0.07 (0.04 to 0.10) −0.76 (−4.14 to 2.74), p = 0.643 0 [2010 to 2024] −0.76 (−4.14 to 2.74), p = 0.643 — —
Group 2 to 5 PH Race/Ethnicity
Non-Hispanic White 7.91 (7.79 to 8.04) 11.32 (11.18 to 11.45) 2.65 (1.33 to 3.98), p <0.001 2 [2010 to 2018] 1.94 (1.33 to 2.55), p <0.001 [2018 to 2021] 7.53 (0.82 to 14.69), p = 0.032 [2021 to 2024] −0.19 (−3.13 to 2.84), p = 0.885
Non-Hispanic Black 11.04 (10.61 to 11.47) 15.71 (15.27 to 16.15) 2.56 (0.96 to 4.18), p = 0.0016 2 [2010 to 2018] 1.82 (1.03 to 2.62), p <0.001 [2018 to 2021] 7.12 (−0.87 to 15.76), p = 0.074 [2021 to 2024] 0.10 (−3.57 to 3.90), p = 0.954
Non-Hispanic Asian or Pacific Islander 4.03 (3.61 to 4.45) 4.95 (4.62 to 5.28) 1.90 (−0.48 to 4.33), p = 0.118 1 [2010 to 2012] −6.34 (−21.93 to 12.37), p = 0.442 [2012 to 2024] 3.34 (2.55 to 4.14), p <0.001 —
Non-Hispanic American Indian or Alaska Native 8.51 (6.86 to 10.16) 10.03 (8.62 to 11.44) 3.15 (1.58 to 4.75), p <0.001 0 [2010 to 2024] 3.15 (1.58 to 4.75), p <0.001 — —
Hispanic/Latino 4.40 (4.10 to 4.71) 6.51 (6.23 to 6.79) 2.71 (0.39 to 5.09), p = 0.022 2 [2010 to 2018] 2.01 (1.08 to 2.94), p = 0.001 [2018 to 2021] 12.14 (−0.16 to 25.96), p = 0.053 [2021 to 2024] −4.17 (−8.82 to 0.72), p = 0.082
Proportionate PH Deaths versus CVD Deaths (%)
Group 1 PH 0.029% 0.018% −3.35 (−8.05 to 1.59), p = 0.181 2 [2010 to 2018] 2.14 (0.09 to 4.24), p = 0.043 [2018 to 2021] −17.36 (−35.80 to 6.39), p = 0.118 [2021 to 2024] −2.47 (−12.59 to 8.83), p = 0.607
Groups 2 to 5 PH 1.53% 2.08% 2.16 (1.94 to 2.38), p <0.001 0 [2010 to 2024] 2.16 (1.94 to 2.38), p <0.001 — —
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Aug 8, 2026 | Posted by in CARDIOLOGY | Comments Off on National Patterns of Pulmonary Hypertension Mortality in the United States, 2010 to 2024

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