High blood pressure puts stress on your arteries and the heart muscle — find out what you should do and why even elevated blood pressure that isn’t hypertension can be dangerous.

Published: May 25, 2022 | Updated: April 5, 2024

The cause of high blood pressure in young adults isn’t always known, but addressing obesity, sedentary lifestyle and excessive alcohol or salt can be the first steps toward bringing your blood pressure down.

Some patients with high blood pressure may not notice a difference in how they feel, but over time, the increased stress on your arteries and the heart muscle will decrease the flow of blood and oxygen to your heart and can cause chest pain, heart attack and ultimately heart failure.

High blood pressure in young adults is not uncommon. Nearly a quarter of those between the ages of 18 and 39 had hypertension, according to the National Health Statistics Reports published in June 2021. The condition is more common in men than women, and African Americans are especially at risk.

Knowing what a good blood pressure number is and getting yours checked regularly can help you take the steps to avoid long-term complications.

High blood pressure — even if it isn’t hypertension — is still dangerous.

Even if your blood pressure falls short of the formal hypertension diagnosis, you still could be at risk for heart damage.

High blood pressure in young adults, even if merely “elevated” and not at the level of a hypertension diagnosis, can lead to heart failure at a young age, especially in African American patients, according to cardiologist Kelly C. McCants, M.D., executive medical director of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program and executive director of the Institute for Health Equity, a Part of Norton Healthcare.

“If you’re African American, that target clearly should be under 120 for your systolic, and your diastolic should be less than 80,” Dr. McCants said.

Often, patients with 120/80 blood pressure would be considered at the bottom end of what’s considered “elevated” blood pressure or even in the “normal” range.

According to Dr. McCants, a patient resting in a health care provider’s office may show borderline hypertension, but when stressed or exercising the systolic pressure can double. And for patients who have been going on for years with blood pressure that was short of meeting the hypertension diagnosis, they still can experience significant thickening of the left ventricle muscle.

For some young adults with high or merely “elevated” blood pressure, medication to reduce blood pressure may be an appropriate addition to lifestyle changes. Blood pressure that’s elevated can accelerate to cardiomyopathy — a weakened heart — particularly in African Americans and other people of color, according to Dr. McCants.

“If someone has hypertension in their 30s, you can bet that if they make it 30 more years and their blood pressure remains uncontrolled, there is a good chance they could have end organ damage from prolonged hypertension like kidney failure, stroke or heart failure,” he said.

Medications can include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta blockers and diuretics.