Arterial hypertension in young adults: risk factors, clinical assessment, and evidence-based management.

Abstract

Arterial hypertension in young adults is an increasingly important contributor to long-term cardiovascular and renal morbidity. Early-onset hypertension is frequently underdiagnosed due to asymptomatic presentation, measurement variability, and white-coat or masked hypertension, highlighting the value of ambulatory or home blood pressure monitoring for confirmation. Risk factors include obesity, high sodium intake, physical inactivity, alcohol and tobacco use, stress, sleep disorders, and medication or substance-related effects, while secondary causes should be considered when hypertension is severe, resistant, or clinically atypical. Clinical assessment aims to confirm persistent elevation, quantify global cardiovascular risk, detect hypertension-mediated organ damage, and evaluate for reversible secondary etiologies when appropriate. Management prioritizes lifestyle intervention (weight control, exercise, DASH-type diet, sodium reduction, moderation of alcohol, smoking cessation, and sleep optimization) and introduces pharmacotherapy when blood pressure remains uncontrolled or when overall risk is elevated. Evidence-based treatment and sustained follow-up in young adults can meaningfully reduce lifetime risk of stroke, coronary disease, heart failure, and chronic kidney disease.