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High Blood Pressure In Young Adults: AHA Announces First New Guidelines Since 2017
September 08, 2025 / 16:38 IST
The elderly and middle-aged are no longer the only groups that should be concerned about high blood pressure. These days, doctors are warning more and more that younger adults are also at risk and that failing to recognise early warning signs could pave the way for heart disease, stroke, and even memory loss in later life.
In a ground-breaking move, the American Heart Association (AHA) and the American College of Cardiology (ACC) have announced their first major guideline update in eight years. The focus has shifted from just controlling numbers to preventing long-term complications, with a special emphasis on younger adults.
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The categories themselves remain the same:
Normal: below 120/80 mm Hg
Elevated: 120–129/<80 mm Hg
Stage 1 hypertension: 130–139/80–89 mm Hg
Stage 2 hypertension: 140/90 mm Hg or higher
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The difference lies in when doctors intervene. The update introduces the PREVENT risk calculator, a tool designed to predict a person's 10- to 30-year cardiovascular disease risk by analysing multiple health factors. For young adults with stage 1 hypertension, a higher PREVENT score could mean earlier medication—rather than waiting for years of silent damage to unfold.
This change comes at a critical time. Nearly one in four Americans aged 18–39 already shows elevated or high blood pressure, but awareness and treatment remain low. The risk of chronic illnesses like heart attacks, strokes, and cognitive decline rises with even mild, untreated hypertension.
A DASH-style diet, drinking less or not at all, maintaining a healthy weight (even a 5% weight loss can lower blood pressure), managing stress, getting enough sleep, and consuming no more than 1,500 mg of sodium per day are among the lifestyle changes that are highlighted in the updated recommendations.
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What younger adults can do right now:
Secondary Hypertension In Young Adults With Hypertension Common Despite Age, BP
Secondary hypertension among young adults with hypertension is common regardless of blood pressure (BP) level and age, according to study findings published in Hypertension.
Investigators sought to describe the causes and prevalence of secondary HTN among young adults.
The investigators conducted a cross-sectional study using computerized electronic health records for consecutive patients referred to the Georges Pompidou Hospital (HEGP) Hypertension Unit, Paris, France, and the Bordeaux University Hospital Hypertension Unit, Bordeaux, France, from January 2019 through January 2023. Overall, 2090 patients aged 18 to 40 years with confirmed hypertension were included in the analyses. Patients with hypertension diagnosed during childhood were excluded.
Patients (mean age at diagnosis, 29.8 years; 47.2% men) mostly had family history of hypertension (59.6%), body mass index (BMI) of greater than 25 (66.9%), and few had diabetes (4.7%). Nearly half were taking at least 2 antihypertensive drugs (43.5%), 18.8% had potassium levels below 3.5 mmol/L, and 27.7% were current smokers.
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…2HTN [secondary hypertension] is frequent and significantly more common in patients with hypertension aged 18 to 40 years than the prevalence reported in the general hypertensive population.
The investigators found 29.6% of patients had secondary HTN, which was most frequently associated with primary aldosteronism (54.8%), renovascular hypertension (18.4%), primary kidney disease (12.9%), pheochromocytoma/functional paraganglioma (6.0%), and hypertension caused by drugs or substances (5.2%).
Regardless of the number of treatments, a lower prevalence of secondary HTN was not found among patients with BP of less than 160/100 mm Hg. Patients aged between 30 and 40 years had a greater prevalence of secondary HTN compared with those aged 18 to 30 years (P =.024).
Diabetes, BMI of less than 25, no familial history of hypertension, treatment with at least 2 medications, hypokalemia, and female sex were associated with higher prevalence of secondary HTN.
Study limitations include possible residual referral bias, hyperparathyroidism was not evaluated, thyroid dysfunction was not considered for analysis, and there was no control group aged greater than 40 years.
"According to our study, 2HTN [secondary hypertension] is frequent and significantly more common in patients with hypertension aged 18 to 40 years than the prevalence reported in the general hypertensive population," the investigators concluded. "We failed to identify a population with a low risk of 2HTN, and studies analyzing precisely the determinants of each cause of 2HTN are needed to narrow the population of patients at risk for 2HTN."
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This article originally appeared on The Cardiology Advisor
Hypertension Prevalence 22.7% Among Young Adults
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