From the Guidelines
If you have high blood pressure at age 21, you should see a healthcare provider for proper evaluation, including comprehensive blood work, as high blood pressure at a young age increases long-term risks for heart disease, stroke, and kidney problems 1.
Importance of Evaluation
High blood pressure in young adults is a significant concern, as it can lead to various complications, including cardiovascular and renal diseases. The American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline recommends that the definition of hypertension be lowered to 130/80 mm Hg, which implies that an additional 14% of the adult U.S. population meets criteria for hypertension 1.
Blood Work and Tests
Blood tests typically include:
- Complete blood count
- Metabolic panel (checking electrolytes, kidney and liver function)
- Lipid profile
- Thyroid function
- Possibly tests for hormonal causes of hypertension like aldosterone and renin levels Young adults with high blood pressure often need investigation for secondary causes rather than assuming it's essential hypertension.
Lifestyle Modifications and Treatment
Your doctor may recommend lifestyle modifications first, including:
- Reducing sodium intake
- Regular exercise
- Maintaining healthy weight
- Limiting alcohol
- Avoiding tobacco If medication is needed, ACE inhibitors (like lisinopril), ARBs (such as losartan), or calcium channel blockers (like amlodipine) are commonly prescribed for young adults, starting at low doses 1.
Regular Monitoring
Regular monitoring is essential, and you may need home blood pressure monitoring to track your readings between appointments. Recognition, diagnosis, education, and effective management are critical to reduce the long-term morbidity and mortality associated with hypertension 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
High Blood Pressure at Age 21
- High blood pressure, or hypertension, is a common condition that affects approximately 116 million adults in the US and more than 1 billion adults worldwide 2.
- It is defined as a persistent systolic blood pressure (SBP) of at least 130 mm Hg or diastolic blood pressure (DBP) of at least 80 mm Hg 2.
- Hypertension is associated with an increased risk of cardiovascular disease (CVD) events, such as coronary heart disease, heart failure, and stroke, as well as death 2, 3.
Blood Work and Diagnosis
- Blood work is typically used to diagnose hypertension, and the results are used to determine the best course of treatment 2.
- The decision to initiate antihypertensive medication is based on the level of blood pressure and the presence of high atherosclerotic CVD risk 2.
- First-line therapy for hypertension includes lifestyle modification, such as weight loss, a healthy dietary pattern, physical activity, and moderation or elimination of alcohol consumption 2, 3.
Treatment Options
- First-line drug therapy for hypertension consists of a thiazide or thiazide-like diuretic, an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and a calcium channel blocker 2, 4.
- Angiotensin receptor blockers (ARBs) have been shown to be effective in lowering blood pressure and reducing the risk of CVD events 4, 5, 6.
- Losartan, an ARB, has been shown to have a comparable antihypertensive effect to other medications, such as amlodipine and lisinopril, but with superior tolerability 5.
- The antiatherosclerotic effect of losartan has also been shown to be comparable to that of ACE inhibitors, with fewer adverse effects 6.