Study Reveals High Blood Pressure Affects Half a Million Post-9/11 Veterans, With Significant Undiagnosed Cases

A new analysis 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 study, which examined data from over one million veterans with an average age of 33.5 years, found that 45% of men and women veterans met the clinical definition of high blood pressure.

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.

‘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. ‘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.’

Researchers used electronic health records from the Veterans Health Administration to examine data from veterans who received medical care between 2001 and 2023. 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. Among individuals with high blood pressure, researchers further identified if veterans had undiagnosed high blood pressure (those without a documented diagnosis) and untreated high blood pressure (individuals without prescription fills for blood pressure-lowering medications).

‘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, noted the concerning implications. ‘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 researchers say their findings highlight the need for strategies that promote a heart-healthy lifestyle starting at a young age. The American Heart Association defines optimal heart health through its Life’s Essential 8 metrics, which include four health behaviors and four health factors. 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.

The study has several limitations, including its observational nature which cannot prove direct cause and effect, potential missed or misclassified cases of high blood pressure, and the exclusion of medical care or prescriptions veterans may have received outside the Veterans Health Administration system. The CDC received no funding for this study, and the statements and conclusions in the manuscript are solely those of the study authors.

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