A study of nearly 300,000 South Korean adults found that individuals with higher blood pressure during young adulthood face substantially increased risks of developing heart and kidney disease after age 40. The research, presented at the American Heart Association's EPI|Lifestyle Scientific Sessions 2026, indicates that maintaining optimal blood pressure levels before midlife is crucial for long-term cardiovascular and renal health.
According to the analysis of Korean National Health Insurance Service database records, adults who had elevated or high blood pressure that remained higher from age 30 to 40 showed significantly greater likelihood of developing heart disease, stroke, or kidney disease in midlife. Specifically, having a systolic blood pressure reading approximately 10 mm Hg higher than peers for about 10 years was associated with a 27% higher risk of heart disease and a 22% higher risk of kidney disease. Similarly, participants with diastolic blood pressure about 5 mm Hg higher than their peers for approximately 10 years faced a 20% increased heart disease risk and 16% higher kidney disease risk.
"Young adults often have a very low predicted 10-year risk of heart disease, even when they have elevated or high blood pressure," said Hokyou Lee, M.D., Ph.D., FAHA, an associate professor of preventive medicine at Yonsei University College of Medicine in Seoul. "Our study's findings show that blood pressure levels in early adulthood are important even if short-term risk appears low. Long-term exposure to higher blood pressure from early life may accumulate damage over time, increasing the risk of heart and kidney disease in midlife."
The study's design involved analyzing health information for 291,887 adults who were 30 years old in 2002-2004 and received routine health screenings between age 30 and 40. Participants had no prior history of heart or kidney disease before age 40, with 76.3% being men. Researchers calculated each participant's cumulative blood pressure levels from age 30 to 40 to account for both how high it was and how long it remained elevated. Participants were then followed for approximately 10 years after age 40, during which development of heart or kidney disease was identified through national health service records.
The findings revealed stark contrasts between blood pressure groups. Compared with people in the lowest 20% of cumulative blood pressure levels during young adulthood, those in the highest 20% were significantly more likely to develop heart or kidney disease in midlife. People in the highest cumulative systolic blood pressure group were about 3.5 times more likely to develop heart conditions than those in the lowest group, while the risk of kidney disease was approximately 3 times higher among people with the highest cumulative systolic blood pressure.
This research carries important implications for public health approaches to hypertension management. According to the American Heart Association's 2026 Heart Disease and Stroke Statistics, nearly half of U.S. adults live with high blood pressure, which remains the leading cause of cardiovascular disease and premature death both in the U.S. and worldwide. The study reinforces that blood pressure management should begin early in adulthood rather than waiting until midlife when damage may already be accumulating.
"Maintaining optimal blood pressure is a concern for every individual, at every age," Lee emphasized. "Early prevention, diagnosis, monitoring and treatment, if needed, are investments in future heart and kidney health. Timely treatment of elevated blood pressure is essential to reduce the effects of years of exposure, which underscores the importance of monitoring and managing blood pressure as soon as a patient has elevated blood pressure levels."
The American Heart Association's 2025 High Blood Pressure Guideline already recommends treatment of stage 1 hypertension in adults with low predicted 10-year risk of cardiovascular disease after 3-6 months of lifestyle modification. Daniel W. Jones, M.D., M.A.C.P., FAHA, an American Heart Association volunteer expert, noted that "this study from Korea emphasizes the risk from high blood pressure begins at an early age and early in the course. The opportunity in this study to evaluate cumulative blood pressure over several years was important in understanding that risk."
An important limitation of the study is that it featured research abstract findings that have not yet undergone peer review, with the results considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. Additionally, participants received care through South Korea's universal health care system with standardized pricing for all health care, which may affect generalizability to other health systems. The study should encourage the design of randomized clinical trials to document that early treatment of high blood pressure in young adults effectively reduces risk for cardiovascular and kidney disease.
