Health experts on 4 September 2025 urged earlier action on high blood pressure after data show rising heart attacks and strokes among people under 40 in the US: new guidance expands prevention advice, introduces a longer-term risk calculator and updates diet, medication and pregnancy recommendations to reduce future cardiovascular disease.
Key Takeaways
- New guidance emphasizes early prevention as hypertension increases among younger adults; about 25% of 18–39-year-olds meet the 130/80 mm Hg threshold for hypertension.
- The American Heart Association released the PREVENT risk calculator to estimate 10- and 30-year cardiovascular risk for ages 30–79, adding social drivers (zip code) to clinical factors.
- Dietary updates favour potassium-based salt substitutes, a target sodium intake below 2,300 mg per day with an ideal goal of 1,500 mg, and promotion of the DASH dietary pattern.
- Medication guidance now includes consideration of GLP-1 receptor agonists for some overweight or obese patients with high blood pressure.
- Specific guidance addresses managing hypertension before, during and after pregnancy because of elevated maternal risk.
- CDC data show nearly half of US adults had hypertension in 2020–2023 (47.7%), yet many remain unaware or untreated; overall blood pressure control is poor (about 21%).
- Strokes among Americans under 45 have risen by nearly 15% since 2011; contributors include higher blood pressure, obesity and substance use.
Verified Facts
The American Heart Association updated its hypertension guidance for the first time since 2017, placing stronger emphasis on prevention and on tools to estimate longer-term risk. The new PREVENT (Predicting Risk of cardiovascular disease EVENTs) calculator estimates both 10- and 30-year cardiovascular risk for people aged 30 to 79, using age, sex, blood pressure, cholesterol, medications, diabetes, smoking and zip code as a proxy for social determinants of health.
Population data cited in the guidance and associated reports show a substantial burden of high blood pressure. A 2024 CDC analysis found that 47.7% of adults aged 18 and older had hypertension between 2020 and 2023. Within that group, awareness and treatment vary sharply by age: roughly 59% of people with hypertension were aware of it and about half were taking medication; among 18–39-year-olds just 27% were aware and 14% were receiving treatment, while 74% of people 60 and older were aware and 69% were treated.
Clinically, hypertension is defined in these guidelines as sustained readings above 130/80 mm Hg. Uncontrolled high blood pressure is linked to increased risks of heart disease, stroke, kidney disease, cognitive decline and dementia. In the US, high blood pressure was identified as a primary or contributing factor in about 685,900 deaths in 2022.
The guidance updates non-pharmacologic measures: recommending the DASH-style diet (high in vegetables, fruits, whole grains, legumes, nuts and low-fat dairy), reducing sodium toward a 1,500 mg daily goal if possible, choosing potassium-based salt substitutes for home cooking, limiting alcohol to no more than two drinks daily for men and one for women, and increasing aerobic and resistance exercise to 75–150 minutes a week depending on intensity.
Context & Impact
Younger adults have experienced a slight rise in hypertension prevalence while older age groups saw small declines. The increase among the young is a public-health concern because early-onset high blood pressure accelerates lifetime cardiovascular risk and contributes to the observed rise in strokes and cardiac events in people under 45.
Public health implications include missed opportunities for screening and prevention: many younger adults do not routinely check blood pressure, have lower awareness of hypertension, and are less likely to be treated. This pattern undermines national goals to reduce hypertension prevalence and improve control by 2030.
Clinicians will need to balance earlier screening and preventive treatment with careful risk stratification. The PREVENT tool is intended to support longer-term decision-making, but it also raises questions about access, equity and how social drivers embedded in risk calculators should influence care priorities.
Wider adoption of potassium-based salt substitutes and dietary shifts could lower population systolic blood pressure, but implementation requires clear consumer guidance and attention to populations who must avoid potassium supplements (for example, some people with kidney disease).
“The revamped guidance aims to address the growing burden of morbidity and mortality attributable to high blood pressure by prioritizing prevention and longer-term risk assessment.”
American Heart Association
Unconfirmed
- Long-term population impact of adding GLP-1 medications for blood pressure management remains uncertain; broader real-world evidence is still emerging.
- How quickly PREVENT will be adopted in routine primary care and whether zip-code inputs improve outcomes across diverse populations is not yet established.
Bottom Line
The new guidance pushes clinicians and the public to act earlier on blood pressure, using prevention, lifestyle measures and targeted therapies to curb a troubling rise in cardiovascular events among younger adults. Improving screening, awareness and equitable access to care will be essential to translate these recommendations into fewer heart attacks, strokes and deaths.