High blood pressure in young adults: AHA announces first new guidelines since 2017

The first update since 2017 highlights long-term prevention with the PREVENT™ risk calculator, earlier interventions, and lifestyle changes for people in their 20s and 30s. (Image: Pexels)

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

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:

• Regularly monitor blood pressure at home and during clinic visits.
• Constantly keep your doctor in loop and report your PREVENT risk scores
• Develop healthy habits like eating clean, exercise, less stress, and reduced intake of top priority.
• Use verified monitors rather than smartwatches for accurate readings.
• If the blood pressure remains elevated for a longer period, take immediate steps and visit the doctor for guidance