Study Reveals High Blood Pressure Burden Among Younger Post-9/11 Veterans, With Significant Undiagnosed Cases

A new study published in the Journal of the American Heart Association reveals that approximately half a million post-9/11 U.S. veterans have high blood pressure, with about half of those cases undiagnosed and one quarter untreated. The research, which analyzed data from over one million veterans with an average age of 33, found that 45% of men and women veterans met the clinical definition for high blood pressure. This study is among the first to examine high blood pressure specifically in younger post-9/11 veterans accessing care through the Veterans Health Administration.

Lead study author Tiffany Chang, Ph.D., an epidemiologist at the U.S. Centers for Disease Control and Prevention, emphasized the importance of early intervention. "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," Chang said. "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."

The study identified significant disparities among different demographic groups. 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. While women were 5% less likely to have high blood pressure, 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, though they had more primary care visits and were less likely to have their condition 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.

Daniel W. Jones, M.D., M.A.C.P., FAHA, an American Heart Association volunteer expert and past president, expressed concern about the findings. "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," Jones said. "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." The researchers say their findings highlight the need for strategies that promote a heart-healthy lifestyle starting at a young age, referencing the American Heart Association's Life's Essential 8™ metrics for optimal cardiovascular health.

The study's methodology involved examining electronic health records from the Veterans Health Administration between 2001 and 2023, using blood pressure measurements, medical diagnoses and prescription medication fill data to identify individuals with high blood pressure. 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. 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, providing context for the veteran-specific findings. Researchers acknowledge limitations including the observational nature of the study, which cannot prove direct cause and effect, and the possibility that some cases may have been missed if veterans received care outside the VA system.