Trends in Hypertension Prevalence, Awareness, Treatment, and Control Among US Young Adults, 2003–2023

BACKGROUND: This study evaluated recent trends in hypertension prevalence and management among US young adults, and assessed disparities by age, sex, or race and ethnicity, as well as potential factors contributing to the age-related disparities. METHODS: Data from 51,291 adults aged ≥18 years in the National Health and Nutrition Examination Survey 2003-2004 to 2021-2023 were analyzed. Stage 1 or 2 hypertension was defined as systolic/diastolic blood pressure (BP) ≥130/80 mmHg or antihypertensive medication use. Hypertension awareness and treatment were based on self-report. RESULTS: In 2021-2023, 21.3% (20.4 million) young adults aged 18-39 years had stage 1 or 2 hypertension, of whom only 28.3% were aware of their condition and 5.6% achieved BP control to <130/80 mm Hg. While hypertension prevalence among young adults remained stable from 2003-2004 to 2021-2023, awareness and control declined after 2013-2014, though no apparent change in control rates was observed between 2017-2020 and 2021-2023. Compared to adults aged ≥40 years, young adults had lower rates of awareness, treatment, and control, with lower rates of having a routine place for healthcare explaining 7%-16% of the gaps. Disparities in hypertension awareness, treatment, and control were greatest among young adult men, non-Hispanic Black, and Hispanic individuals compared with other sex and racial and ethnic subgroups. CONCLUSIONS: In 2021-2023, one in five US young adults had hypertension, yet awareness and control have declined since 2013-2014 and remain low.