A study published today in the Journal of the American Heart Association found that nearly half of post-9/11 U.S. veterans receiving care through the Veterans Health Administration have high blood pressure, and among those, about half were undiagnosed and one quarter were untreated. The research, which analyzed data from over one million veterans with an average age of 33 years, underscores the significant burden of hypertension in this younger population and the critical need for early detection and management.
Lead study author Tiffany Chang, Ph.D., an epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC), noted that veterans have higher rates of risk factors such as posttraumatic stress disorder and direct combat exposure, which may contribute to increased hypertension risk compared to non-veterans. “Earlier prevention and management of high blood pressure are key to reducing the risk of heart disease and stroke and improving long-term health outcomes,” Chang said.
The study identified notable disparities by sex, race, and ethnicity. Men were more likely than women to have high blood pressure and also had higher rates of smoking, alcohol or drug use, obesity, and diabetes. However, women with hypertension were 17% more likely to be undiagnosed. Black veterans were 9% more likely to have high blood pressure than white veterans, yet they had more primary care visits and were less likely to have undiagnosed or untreated hypertension. Hispanic veterans were 5% more likely to have undiagnosed hypertension and 7% more likely to have untreated hypertension compared to white veterans.
Daniel W. Jones, M.D., M.A.C.P., FAHA, an American Heart Association volunteer expert and past president, emphasized the importance of these findings. “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 used electronic health records from the Veterans Health Administration spanning 2001 to 2023, defining high blood pressure based on outpatient measurements (≥140/90 mm Hg), medical diagnoses, and prescription fills for blood pressure-lowering medications. The analysis also examined undiagnosed hypertension (no documented diagnosis) and untreated hypertension (no prescription fill).
Study limitations include its observational nature, which can identify associations but not causation, and the potential for missed or misclassified cases. The study did not include care received outside the VA system. The American Heart Association’s Life’s Essential 8 metrics—including healthy diet, physical activity, smoking cessation, and sleep—are key to maintaining cardiovascular health. The American Heart Association’s 2026 Statistical Supplement reports that nearly half of all U.S. adults had high blood pressure between 2021 and 2023.
These findings highlight the urgent need for targeted prevention strategies, especially for higher-risk groups such as Black and Hispanic veterans, to reduce the long-term burden of cardiovascular disease.
