Trends in Hypertension Prevalence, Awareness, Treatment, and Control Among US Young Adults, 2003-2023.
Level 4 - case-series / case-control
Serial cross-sectional population survey (NHANES)
PubMed 40156902 · doi:10.1093/ajh/hpaf044
What was done
Researchers analyzed data from 51,291 US adults aged 18 years and older participating in the National Health and Nutrition Examination Survey (NHANES) from 2003–2004 through 2021–2023. They evaluated trends in hypertension prevalence, awareness, treatment, and control among young adults (aged 18–39 years) and examined disparities across age, sex, and race/ethnicity. Hypertension (stage 1 or 2) was defined as blood pressure (BP) ≥130/80 mm Hg or antihypertensive medication use; awareness and treatment were self-reported, and BP control was defined as <130/80 mm Hg.
What was found
In 2021–2023, 21.3% (approximately 20.4 million) of US young adults had stage 1 or 2 hypertension. Among those with hypertension, only 28.3% were aware of their diagnosis and 5.6% achieved BP control. While overall hypertension prevalence in young adults remained stable across 2003–2023, awareness and control declined after 2013–2014 (with no apparent change in control rates between 2017–2020 and 2021–2023). Compared with adults aged ≥40 years, young adults had significantly lower awareness, treatment, and control rates, with lower routine healthcare access explaining 7% to 16% of the gap. Disparities in awareness, treatment, and control were greatest among young adult men, non-Hispanic Black, and Hispanic individuals.
Why it matters
One in five US young adults has hypertension, yet fewer than one in seventeen achieves blood pressure control, reflecting a decade-long drop in awareness and management that poses long-term cardiovascular risk.
Limits
The analysis relies on repeated cross-sectional surveys rather than longitudinal follow-up, preventing causal conclusions. Awareness and treatment were based on self-report, and the specific sub-sample size for the 18–39 age bracket was not reported in the abstract.
Cited by
- supports Almost 50% of US adults have hypertension, and 20% of young adults aged 18 to 39 have hypertension.