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- New research suggests deaths from hypertension-related heart disease among women ages 25 to 44 have more than quadrupled over the past two decades.
- The increase may reflect both lifestyle changes and improved detection and reporting.
- To lower risk, younger women should focus on diet and exercise—while also paying attention to factors unique to this stage of life.
Deaths linked to high blood pressure are on the rise in a group of people you might not expect: younger women. A new study that will be presented at the American College of Cardiology’s 2026 Scientific Sessions this week—but has not yet been published in a peer-reviewed journal—found that, between 1999 and 2023, the number of hypertension-related heart disease deaths among women ages 25 to 44 more than quadrupled. Here’s what might be behind the trend—and what younger women can do to protect themselves.
An Overlooked Group
High blood pressure is often asymptomatic and occurs when the force of blood against artery walls is consistently too high. It’s a major contributor to heart disease because this extra strain forces the heart to work harder, which thickens and weakens the muscle over time.
Despite heart disease being the leading killer of women, as it is in men, women have historically been underrepresented in cardiovascular research, including studies on blood pressure, said lead study author Alexandra Millhuff, DO, a resident physician at the University of New Mexico. This gap is especially pronounced among younger women.
“For decades, cardiovascular disease was seen mainly as a problem for older men,” said Brett Sealove, MD, FACC, FAHA, RPVI, CPE, chair of cardiology at Hackensack Meridian Jersey Shore University Medical Center. “Young women were considered low-risk by default, creating a significant blind spot in clinical practice and research.”
What Researchers Found
To highlight this often-overlooked group, Millhuff and her colleagues analyzed death certificate data from the CDC WONDER public health database. They focused on deaths from hypertensive heart disease in women ages 25 to 44 between 1999 and 2023, using age-adjusted mortality so that trends reflect true risk rather than changes in population size or age.
The results were striking: Over this 24-year span, the death rate from hypertensive heart disease climbed from 1.1 per 100,000 in 1999 to 4.8 per 100,000 in 2023.
Risk was highest among non-Hispanic Black women, followed by non-Hispanic white and Hispanic women. Rates also varied by region, with women in the South facing double the risk of those in the West.
“Social determinants of health, limited access to care, economic stress, and under-resourced communities likely also play a role when you look at the geographic clustering in states like Mississippi, Louisiana, and West Virginia,” Sealove said.
What’s Behind the Rise?
Some of the potential increase may reflect broader public health trends that have driven up hypertension-related deaths across the U.S. A 2022 study, for example, found that among adults ages 35 to 64, hypertension-related cardiovascular disease deaths at the county level rose from about 23 per 100,000 people in 2000 to nearly double that by 2019.
Rising rates of obesity and metabolic syndrome are “certainly part of the story,” said Sealove, along with more sedentary lifestyles and poorer diets. Sleep also plays a role: Disrupted rest and conditions like sleep apnea can increase the risk of hypertension, Goldberg noted. A 2024 Gallup poll actually found that younger women, in particular, report getting less sleep and experiencing more stress than other groups.
But Sealove believes much of the rise may simply come down to better recognition. We’re identifying “cases, and unfortunately, deaths, that were previously attributed to other causes or simply not captured correctly,” he said.
What Younger Women Can Do
Hypertension-related deaths among younger women are still relatively rare compared with older adults—but experts said prevention is still critical for this age group.
For younger women, strategies are largely the same as those for other groups. Following a low-salt, heart-healthy eating pattern, such as the Mediterranean or DASH diet, and staying active with regular aerobic exercise like walking, cycling, jogging, or dancing can all help keep blood pressure in check, Goldberg said.
At the same time, younger women face some unique risk factors that are important to discuss with a doctor. Millhuff noted that certain reproductive conditions—like hypertensive disorders during pregnancy—can signal higher long-term cardiovascular risk. The use of estrogen-containing oral contraceptives can also raise blood pressure in some women, Sealove added. “Yet this risk isn’t always discussed proactively, particularly with younger patients who may be on these medications for years,” he said.
Milhuff also emphasized the importance of regular blood pressure checks. Knowledge is power when it comes to keeping numbers low. “Don’t dismiss a high reading because you’re young,” Sealove added. “I hear this from patients all the time: ‘But I’m only 35.’ Age is not a protective factor if the other risk elements are present.”
