Recent industry studies on the long-term effects of high blood pressure are revealing the importance of early prevention and intervention, particularly in young adults below age 40 before symptoms arise.

Historically, elevated blood pressure or high cholesterol in young adults has been monitored, but several studies now support earlier screening and management to address the root causes of cardiovascular disease more proactively through a risk prevention model rather than a risk mitigation approach.

Several studies have examined the potential for prevention, intervention, and the building of heart-healthy habits beginning as early as pregnancy, early childhood, and young adulthood — before symptoms even appear. Highlights of these studies, published in an article in Cardiology magazine,¹ include the following:

• Nutritional counseling and prenatal guidance regarding the value of lower sugar intake during pregnancy, fetal development, and early childhood demonstrated a reduced risk for heart failure, stroke, and cardiovascular disease death decades later.
• Dietary counseling from 7 months to 20 years of age, with follow-up in the mid-20s, showed benefits in all areas of cardiovascular disease risk.

Updated joint guideline
Nearly half of U.S. adults have hypertension, according to the American Heart Association’s 2026 Heart Disease and Stroke Statistics.²

High blood pressure is the number one controllable risk factor for stroke, and prolonged periods of elevated blood pressure can lead to premature heart attack, heart failure, and renal failure. Rates of uncontrolled hypertension have increased over the past decade, according to the American College of Cardiology.³

High blood pressure is also the most common and modifiable risk factor for heart disease.⁴ The growing recognition of the role of long-term hypertension in other chronic conditions — and the importance of modifying risk through early intervention — is reflected in the new joint guideline for high blood pressure treatment from the American College of Cardiology and American Heart Association.

While the target threshold for most patients remains unchanged, the 2025 update includes more nuanced and specific recommendations on achieving target blood pressure thresholds, mitigating risk, and driving optimal heart health. The new guideline:

• Uses the American Heart Association’s Predicting Risk of cardiovascular disease EVENTs (PREVENT^tm) calculator to estimate cardiovascular disease risk.
• Has updated guidance for patients with a blood pressure of 130–139/80–89 mm Hg who are at a lower 10-year risk, defined as an estimated risk of 7.5 percent by the PREVENT equation.
• Encourages medication intervention for patients with:
  • A slightly elevated blood pressure and a lower 10-year risk to a target of less than 130/80 mm Hg if blood pressure remains elevated after three to six months of lifestyle modification.
  • An elevated blood pressure (greater than 140/90 mm Hg) regardless of 10-year risk.
  • A slightly elevated blood pressure (greater than 130/80 mm Hg) with a 10-year risk greater than 7.5 percent.
• Showcases an understanding that elevated blood pressure, even in early to midlife, is directly linked with an increased risk of cardiac events and notes that hypertension onset before the age of 45 is associated with a more than twofold greater risk of cardiovascular disease and death.
• Highlights the link between high blood pressure and cognitive impairment and dementia risk.
• Has updated guidance on medication options, including:
  • Early treatment for high blood pressure to reduce the risk of cognitive decline and dementia.
  • Use of newer therapies such as GLP-1 medications for some patients with high blood pressure who are overweigh or obese.
  • Treatment recommendations to manage high blood pressure before, during, and after pregnancy.
• Is likely to increase the number of younger patients who qualify for medication intervention compared to prior guidelines.
• Reaffirms the value of a multidisciplinary approach to blood pressure management, using primary care providers, specialists, pharmacists, nutritionists, and other health professionals to help diagnose, treat, and maintain healthy blood pressure levels.

Resources

There are several resources available for providers and their patients:

• Providers can learn more about best practices for controlling hypertension, accurate coding and documentation, and common billing codes on the Controlling High Blood Pressure resource page on the Cigna for Health Care Professionals website (CignaforHCP.com).
• Providers can access the updated Preventive Care Services (A004) administrative policy on CignaforHCP.com.
• Patient education is available on the Wellness Library page on Cigna.com.
• Providers and patients can access blood pressure education, webinars, and more on the Target: BP website. Target:BP is a national initiative created by the American Heart Association and the American Medical Association that focuses on blood pressure improvement, self-measured blood pressure, patient education, and data collection.
• Providers can learn more about the unique needs of patients relating to high blood pressure and heart health by reading these articles: White coat syndrome: Why it matters and Help your patients take control of their heart health

1. American College of Cardiology. “Moving Upstream: Why the Next Frontier of CV Prevention Begins in Childhood.” American College of Cardiology. 1 April 2026. Retrieved from https://www.acc.org/latest-in-cardiology/articles/2026/04/01/01/feature-moving-upstream.

2. What is High Blood Pressure? | American Heart Association.

3. American College of Cardiology. “High Blood Pressure Focus of New ACC/AHA Guideline.” American College of Cardiology. 1 October 2025. Retrieved from https://www.acc.org/latest-in-cardiology/articles/2025/10/01/01/new-in-clinical-guidance-hbp.

4. American Heart Association. “New high blood pressure guideline emphasizes prevention, early treatment to reduce CVD risk.” American Heart Association. 14 August 2025. Retrieved from https://newsroom.heart.org/news/new-high-blood-pressure-guideline-emphasizes-prevention-early-treatment-to-reduce-cvd-risk.