Increase in hypertension Unawareness Among US Adults

⁤ ⁢ Updated ⁤June⁤ 06,2025

A‌ recent study reveals⁤ a concerning trend: more⁣ U.S. adults are unaware they have hypertension. The research, published⁤ in JAMA Cardiology, indicates ⁤that while awareness of diabetes‌ and‌ high cholesterol remained stable, hypertension unawareness increased between 2013 and 2023. This highlights the need for improved public health strategies⁤ to ⁣enhance the diagnosis ⁢of cardiovascular risk factors, including high blood pressure.

Daniel Y. Johnson, a medical student⁣ at the University of Chicago Pritzker School of Medicine, noted the clinical relevance⁤ of⁤ these findings. “In clinic, I saw many patients who were wholly unaware that they had hypertension, diabetes or high cholesterol,” Johnson told Healio. He added that pandemic-related appointment delays prompted the ‍study to assess ‌changes in awareness of these cardiovascular risk factors.

The study analyzed⁤ data from‌ the ⁤National Health and Nutrition ‍Examination Survey, comparing⁤ survey cycles from ‌2013-2014 and 2021-2023.⁢ The surveys included household interviews and medical⁣ examinations to identify adults with​ hypertension, diabetes, and high total cholesterol, as well as their awareness of⁣ these conditions. Hypertension was defined as ⁢an average systolic BP ‍of at least 140⁢ mm Hg or diastolic BP of at least 90 mm Hg ⁤or prescription for antihypertensive therapy.Diabetes was defined as a‌ HbA1c of 6.5% or more,fasting ​glucose of at ⁢least 126 ‌mg/dL or self-reported clinician’s diagnosis of ​diabetes.High total cholesterol was defined as 240⁢ mg/dL or more or self-reported clinician’s‌ diagnosis of high cholesterol.

The study⁢ encompassed 15,269 adults aged 20 years and older, with⁢ an‌ average age of 57; 46% ​were‌ women.

The ​proportion of adults with hypertension unaware of their condition rose​ from 14.6% ⁢in ⁢2013-2014 to 17.8% in ⁢2021-2023 (P = .017). In contrast,awareness of ​diabetes​ and high cholesterol remained relatively stable,at approximately 28% and 12%,respectively (P for diabetes = .87; P for high cholesterol =.65).

A significant increase in hypertension unawareness was observed among adults aged 20 to ⁣44 years,‍ jumping⁤ from 21.9% in 2013-2014 to 37.1% in 2021-2023 (P < .001). No such changes were seen in ⁣older‌ adults. Similarly,⁢ diabetes and high cholesterol‍ unawareness remained consistent ‍across all age groups between the ​survey⁢ periods.

“It’s alarming⁢ that one in three young adults was unaware of their ⁣high BP,” Johnson told Healio,emphasizing that young adults may ⁣lack regular⁣ preventive screenings and ​underestimate their​ risk. He stressed the importance of addressing this lack of awareness to⁢ prevent future cardiovascular⁢ issues.

Furthermore,hypertension unawareness increased considerably among women,from 11.3% in 2013-2014 to 16.5% in 2021-2023 (P = .001), while no change was observed among men.

“The change in hypertension awareness among women was surprising,” Johnson said, noting that historically, men had slightly worse hypertension awareness. He called for further research to understand this shift and emphasized ‍the ‍urgent need for coordinated⁣ efforts, ⁣including improved⁢ access to preventive screenings and public ‍health campaigns, ​to⁣ combat this public health issue.

We need to do a ⁤better job not ⁤just at diagnosing problems but interacting ‌with patients in⁤ a ‌way to have them understand​ what risk factors they ‍have. ⁣Without that,there will be a big gap in‌ terms of‌ treatment and​ prevention of severe complications like heart attacks and strokes.

Jeffrey S. Berger, MD, NYU Langone Health

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