Early adulthood hypertension linked to heart and kidney disease later in life

Higher blood pressure during young adulthood is likely linked to a higher risk of heart disease and kidney disease later in life, reinforcing the importance of maintaining healthy blood pressure at younger ages, according to preliminary research presented at the American Heart Association's EPI|Lifestyle Scientific Sessions 2026. The meeting is in Boston, March 17-20, and offers the latest epidemiological science on prevention, lifestyle and cardiometabolic health.

Young adults often have a very low predicted 10-year risk of heart disease, even when they have elevated or high blood pressure (a systolic blood pressure measure of 120 mm Hg or higher, or a diastolic blood pressure measure of 80 mm Hg or higher). Our study's findings show that blood pressure levels in early adulthood are important even if short-term risk appears low. Long-term exposure to higher blood pressure from early life may accumulate damage over time, increasing the risk of heart and kidney disease in midlife."

Hokyou Lee, M.D., Ph.D., FAHA, associate professor of preventive medicine at Yonsei University College of Medicine in Seoul, South Korea

According to the American Heart Association's 2026 Heart Disease and Stroke Statistics, nearly half of U.S. adults are living with high blood pressure. It is the leading cause of cardiovascular disease and premature death in the U.S. and worldwide, and it's the most common and most modifiable risk factor for heart disease and stroke. Maintaining healthy blood pressure is critical to preventing or reducing the risk of heart disease, a major cardiac event or a stroke.

In this study, the researchers reviewed medical records from the Korean National Health Insurance Service database. Their analysis found:

• Adults who had elevated or high blood pressure that stayed higher from age 30 to 40 had a higher risk of heart disease, stroke or kidney disease in midlife, after age 40.
• Having a systolic (top number) blood pressure reading of about 10 mm Hg higher than peers for about 10 years was linked to a 27% higher risk of heart disease and a 22% higher risk of kidney disease.
• Participants with a diastolic blood pressure (bottom number) about 5 mm Hg higher than their peers for about 10 years were linked to a 20% higher risk of heart disease and a 16% higher risk of kidney disease.
• Compared with people in the group with the lowest 20% of cumulative blood pressure levels during young adulthood, those in the highest 20% of cumulative blood pressure levels were more likely to develop heart or kidney disease in midlife:
  • People in the highest cumulative systolic blood pressure group were about 3.5 times more likely to develop heart conditions than those in the lowest cumulative systolic blood pressure group.
  • The risk of kidney disease was about 3 times higher among people with the highest cumulative systolic blood pressure.
• Results in this analysis were similar for men and women.

"Maintaining optimal blood pressure is a concern for every individual, at every age," Lee said. "Early prevention, diagnosis, monitoring and treatment, if needed, are investments in future heart and kidney health. Timely treatment of elevated blood pressure is essential to reduce the effects of years of exposure, which underscores the importance of monitoring and managing blood pressure as soon as a patient has elevated blood pressure levels."

The American Heart Association's 2025 High Blood Pressure Guideline recommends treatment of stage 1 hypertension (after 3-6 months of lifestyle modification) in adults with low predicted 10-year risk of cardiovascular disease.

"This study from Korea emphasizes the risk from high blood pressure begins at an early age and early in the course," said Daniel W. Jones, M.D., M.A.C.P., FAHA, an American Heart Association volunteer expert and chair of the writing committee for the Association's Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. "The opportunity in this study to evaluate cumulative blood pressure over several years was important in understanding that risk. The study should encourage the design of randomized clinical trials to document that early treatment of high blood pressure in young adults is effective at reducing risk for cardiovascular and kidney disease." Jones, who was not involved in this study, is a past volunteer president of the Association and dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi.

Study details, background and design:

• The analysis included health information for 291,887 adults from the Korean National Health Insurance Service database, who were 30 years old in 2002-2004 and received routine health screenings between age 30 (2002-2004) and 40 (2012-2014).
• Participants included in the analysis had no prior history of heart or kidney disease before age 40; 76.3% were men.
• The analysis included those who had three or more health examination records with blood pressure measurements taken by health care professionals at the following time periods: at age 30 (2002-2004); at age 40 (2012-2014); and one or more blood pressure measurements taken in between those periods. The median number of blood pressure measurements for each participant was eight.
• Each participant's cumulative blood pressure levels from age 30 to 40 were calculated to account for both how high it was and how long it stayed elevated.
• Participants were followed for about 10 years after age 40, during which development of heart or kidney disease was identified through national health service records. In addition, diagnosis of chronic kidney disease was confirmed by laboratory tests conducted during the follow-up period.
• Deaths from heart or kidney disease after age 40 were identified in the national death records.
• Major health and lifestyle factors, such as sex, income, smoking, alcohol use, physical activity and key health measures, including blood sugar and cholesterol levels, were factored into the analysis.

An important note about the study is that participants received care through the National Health Insurance System in South Korea, a universal health care system for all of its citizens with government-set, standardized pricing for all health care, screening, treatments and medications.