Introduction:

High blood pressure (HBP) constitutes a health problem. Its role as a cause of death can be estimated by multiple-cause coding.

Objectives:

To define the quantitative gain of high blood pressure to determine its real relative contribution as a cause of death in the elderly in Cuba when compared by the multiple-cause methodology with the underlying cause of death.

Methods:

We conducted a descriptive observational study of 582 494 deaths in Cuba between 2013 and 2019. Hypertensive Diseases (I10-I15) were evaluated as a cause of death according to the International Classification of Diseases (ICD-10), the frequency with which high blood pressure was reported as an underlying/contributory cause of death and the total number of times it was mentioned (multiple causes).

Results:

Almost nine out of every 10 persons who die with and due to high blood pressure in Cuba are 60 years of age and older, and the risk of dying with and due to this disease has increased in the seven years analyzed in this population group. The analysis by multiple causes shows a noticeable increase in the number of high blood pressure cases. The ratio between multiple causes and underlying cause of death was around 4; but there was a slight increase in the absolute number of death certificates where high blood pressure was considered the underlying cause of death. The proportional mortality due to high blood pressure, using the analysis of contributory causes, was three times higher than that of the analysis of underlying causes of death (average absolute difference of 8.4%). Cerebrovascular and heart disease are the underlying causes where hypertensive disease most frequently appears as an associated condition.

Conclusions:

High blood pressure is a disease of relatively low frequency as an underlying cause of death in the elderly in Cuba, but frequent as a concurrent or contributory cause, which demonstrates the importance of its prevention and control in this population group.

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