Half a Million Post-9/11 U.S. Veterans Have High Blood Pressure, Many Undiagnosed

A new study published today in the Journal of the American Heart Association reveals that approximately half a million post-9/11 U.S. veterans have high blood pressure, and among them, about half were undiagnosed and one quarter were untreated. The research, which examined data from over one million veterans with an average age of 33 years, underscores the urgent need for early prevention and management of hypertension in this younger population.

“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.”

Using electronic health records from the Veterans Health Administration, researchers identified that nearly half (45%) of men and women veterans met the clinical definition of high blood pressure. Men were more likely to have high blood pressure than women and also had higher rates of smoking, alcohol or drug use, obesity, and diabetes. However, women with high blood pressure were 17% more likely to be undiagnosed. Black veterans were 9% more likely to have high blood pressure compared with white veterans, but they had more primary care visits and were less likely to have undiagnosed or untreated hypertension. Hispanic veterans were 5% more likely to be undiagnosed and 7% more likely to be untreated.

“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, who was not involved in the study, commented: “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.”

The findings emphasize the need for strategies promoting a heart-healthy lifestyle from a young age. The American Heart Association defines optimal heart health through its Life’s Essential 8™ metrics, which include eating better, being more active, quitting tobacco, getting healthy sleep, and managing weight, cholesterol, blood pressure, and blood sugar. According to the American Heart Association’s 2026 Statistical Supplement, nearly half of all U.S. adults (47.3%) had high blood pressure between 2021 and 2023.

The study, which included 1,181,007 post-9/11 veterans with an average age of 33.5 years (12% women), analyzed outpatient blood pressure measurements, medical diagnoses, and prescription data from 2001 to 2023. High blood pressure was defined as ≥140/90 mm Hg, documented diagnosis codes, or prescription fills for blood pressure-lowering medications. Limitations include its observational nature, potential misclassification, and lack of data on care outside the VA system.