Introduction:

Mortality rates "due to" arterial hypertension underestimate the impact of this cause on mortality.

Objective:

To determine the change in the contribution of arterial hypertension to the cause of death, by analyzing all its mentions in the death certificates in Cuba in the period 2013-2019.

Material and Methods:

A descriptive observational study of deaths that occurred in Cuba between January 2013 and December 2019 was carried out. Mortality rates “due to” (basic cause) and “with” arterial hypertension (multiple causes) were calculated. In addition, the most common underlying causes associated with the mention of this condition were determined.

Results:

The risks of dying "due to" and "with" arterial hypertension show an increase. The second risk is, on average, four times higher than the first one, which means that the analysis of mortality "due to" arterial hypertension continues to underestimate the role of this condition within the processes causing death. Both risks are higher for men and adults aged 85 years and older. On average, arterial hypertension was mentioned in some parts of the certificates in 15,7 % of the deaths registered during the period; however, it was declared as the basic cause only in 3,8 % of them. Cerebrovascular and heart diseases are the two underlying causes in which arterial hypertension is the most frequently associated cause.

Conclusions:

The contribution of arterial hypertension to mortality is greater than that identified in the traditional analysis. Having estimates of multiple causes would strengthen health planning and enhance the analyses of disease burden.

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