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Approximately Half a Million Post-9/11 U.S. Veterans had High Blood Pressure

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Research Highlights:

  • About half a million U.S. veterans, who were an average age of about 33 years at the time of the study, had high blood pressure, according to a new analysis.
  • Among this group, men and Black veterans were more likely to have high blood pressure.
  • Women were less likely to have high blood pressure; however, their high blood pressure was more likely to be undiagnosed.
  • Hispanic veterans were more likely to be undiagnosed with high blood pressure.

This study is among the first to examine high blood pressure in younger post-9/11 U.S. veterans who were, on average, 33 years old when accessing care at the Veterans Health Administration.

“Preventing, managing and controlling high blood pressure are essential for protecting cardiovascular health in all adults, including younger adults and those at increased risk of cardiovascular disease,” said lead study author Tiffany Chang, Ph.D., an epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta. “Veterans have higher rates of certain risk factors, such as posttraumatic stress disorder and direct combat exposure, that may contribute to an increased risk of high blood pressure compared to non-veterans. Earlier prevention and management of high blood pressure are key to reducing the risk of heart disease and stroke and improving long-term health outcomes.”

Researchers used electronic health records from the Veterans Health Administration to examine data from over one million post-9/11 U.S. veterans, who were an average age of 33 years. Using blood pressure measurements, medical diagnoses and prescription medication fill data, researchers identified individuals who had high blood pressure, undiagnosed high blood pressure and untreated high blood pressure.

Study findings:

  • Nearly half (45%) of men and women veterans met the study’s clinical definition of high blood pressure.
  • Men were more likely to have high blood pressure compared with women and were also significantly more likely to have risk factors such as being a current or past smoker, alcohol or drug use, obesity and diabetes.
  • Compared with men, women were 5% less likely to have high blood pressure, however, those who did were 17% more likely to be undiagnosed.
  • Black veterans were 9% more likely to have high blood pressure compared with white veterans. However, Black veterans had more primary care visits and were less likely to have their high blood pressure be undiagnosed and untreated.
  • Hispanic veterans were 5% more likely to have undiagnosed high blood pressure and 7% more likely to have untreated high blood pressure, compared with white veterans.

“The high burden of high blood pressure among younger veterans highlights the importance of early prevention strategies, especially for higher-risk populations such as Black and Hispanic veterans,” Chang said. “Stronger prevention and management of high blood pressure earlier in adulthood can help lower the risk of heart disease and stroke later in life.”

Daniel W. Jones, M.D., M.A.C.P., FAHA, American Heart Association volunteer expert and past president of the Association, chair of the writing committee for the Association’s Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults, said, “This is more evidence that high blood pressure is an important issue in young adults. It’s disturbing that so many of these were undiagnosed and untreated, even though they were being seen in the VA health system. If not managed appropriately, many of these young adults will experience heart disease, stroke, dementia and kidney disease as a result of their high blood pressure.” Jones is also dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi and was not involved in this study.

The researchers say their findings also highlight the need for strategies that promote a heart-healthy lifestyle starting at a young age. The American Heart Association defines optimal heart health through its Life’s Essential 8™ metrics - four health behaviors (eat better, be more active, quit tobacco and get healthy sleep) and four health factors (healthy weight and manage cholesterol, blood pressure and blood sugar).

The American Heart Association’s 2026 Statistical Supplement reports that between 2021 and 2023, almost half of all people (47.3%) in the U.S. had high blood pressure.

Study details, background and design:

  • The study group included 1,181,007 post-9/11 younger veterans. Their average age was 33.5 years; and about 12% were women.
  • Study participants received medical care through the Veterans Health Administration between 2001 and 2023.
  • High blood pressure was defined using outpatient blood pressure measurements (≥140/90 mm Hg), documented medical diagnosis codes and prescription fills for blood pressure-lowering medications.
  • Among individuals with high blood pressure, researchers further identified if veterans had undiagnosed high blood pressure (those without a documented diagnosis of high blood pressure) and untreated high blood pressure (individuals who did not have a prescription fill for a blood pressure-lowering medication).
  • The analysis examined differences in hypertension measures by sex, race and ethnicity.

The study has several limitations. Because it is observational, it can identify associations between different data points; however, it cannot prove direct cause and effect. Additionally, some cases of high blood pressure may have been missed or misclassified. The study did not include records of medical care or prescriptions that veterans may have received outside the Veterans Health Administration system.

Co-authors and disclosures are listed in the manuscript. The CDC received no funding for this study.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and American Heart Association Expert Perspective: 214-706-1173

Bridgette McNeill: Bridgette.McNeill@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

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