About 48% of American adults have high blood pressure. That’s roughly 120 million people. The figure comes from the most recent national health survey conducted between August 2021 and August 2023, and it includes both people whose readings are above the threshold and those already taking medication to lower their numbers.
How High Blood Pressure Is Defined
Blood pressure is measured in two numbers: systolic (the pressure when your heart beats) over diastolic (the pressure between beats). The 2025 guidelines from the American Heart Association and American College of Cardiology break readings into four categories:
- Normal: below 120/80
- Elevated: 120 to 129 systolic with diastolic still below 80
- Stage 1 hypertension: 130 to 139 systolic, or 80 to 89 diastolic
- Stage 2 hypertension: 140 or higher systolic, or 90 or higher diastolic
If your numbers fall into two different categories, you’re classified in the higher one. Anything at or above 130/80, or currently being treated with blood pressure medication, counts as hypertension in the national statistics.
How Prevalence Changes With Age
Age is the single strongest predictor. Among adults 18 to 39, about 22% have high blood pressure. That number jumps to nearly 55% for those between 40 and 59. By age 60 and older, three out of four adults (74.5%) are living with it. Blood vessels naturally stiffen over time, and decades of dietary salt, stress, and other wear on the cardiovascular system compound the effect.
This steep climb matters because many younger adults assume high blood pressure is an older person’s problem. One in five adults under 40 already qualifies, often without symptoms.
Differences by Sex
Men are more likely to have high blood pressure than women. In the most recent survey, 50.8% of adult men met the threshold compared with 44.6% of adult women. Hormonal differences offer women some protection before menopause, but that gap narrows significantly with age. By their 60s and 70s, women develop hypertension at rates comparable to men.
Why It Matters: Heart Disease and Stroke
High blood pressure is the leading modifiable risk factor for heart disease and stroke, the two top causes of death in the United States. Sustained pressure damages artery walls, promotes plaque buildup, and forces the heart to work harder with every beat. Over years, this leads to thickened heart muscle, weakened blood vessels, and kidney damage. Most of this happens silently, which is why hypertension is often called a “silent killer.” People typically feel fine until a serious event occurs.
The economic toll is enormous. Annual costs tied to high blood pressure reached an estimated $219 billion in the United States in 2019. On an individual level, people with hypertension spend roughly $2,800 to $2,900 more per year on medical care than those with normal readings. About one in every eight healthcare dollars in the country goes toward cardiovascular disease.
Many People Don’t Know or Aren’t Controlled
Having high blood pressure is one thing. Knowing about it and managing it effectively are separate challenges. A significant portion of Americans with hypertension are either unaware of their condition, not receiving treatment, or being treated but still not reaching target levels. This gap between prevalence and control has been a persistent public health problem, and it worsened during the pandemic years when routine checkups dropped.
Blood pressure is typically checked at a standard doctor’s visit, which means people who skip annual physicals can go years without knowing their numbers. Home blood pressure monitors, widely available for $30 to $60, offer a practical way to track readings between visits. Consistent home monitoring often gives a more accurate picture than a single office reading, which can be artificially elevated by the stress of being in a clinical setting.
What Drives the Numbers Up
Some risk factors are outside your control: age, family history, and sex all play a role. But lifestyle factors account for a large share of cases. Diets high in sodium and low in potassium raise blood pressure. The average American consumes about 3,400 milligrams of sodium per day, well above the recommended limit of 2,300 mg. Physical inactivity, excess weight, heavy alcohol use, and chronic stress all contribute independently, and their effects stack.
For most people, small sustained changes produce measurable drops. Losing even 5 to 10 pounds, cutting sodium intake, exercising 150 minutes per week, and limiting alcohol can each lower systolic pressure by several points. Combined, these changes can rival the effect of a single medication.