Hypertension in adult population under 50 in the population cohort study of Wroclaw citizens (PICTURE): prevalent, undetected, and mostly preventable

Hypertension (HT) is the most common cardiovascular disorder worldwide, with its burden increasingly affecting younger adults. Although early-onset HT is linked to adverse cardiovascular and cognitive outcomes, younger age groups remain underrepresented in prevention and screening programs. This study assessed the prevalence and risk factors of HT in adults under 50 within the PICTURE cohort. The study group consisted of 1107 participants aged 25–49 years enrolled between 2019 and 2022. HT was determined by patient-reported diagnosis/antihypertensive use and/or average of two BP measurements ≥140/90 mmHg. Results: HT was found in 13% of participants under 40 and 20% of participants aged 40 and above. Of 60.0% of participants under 40 and 51.6% of participants aged 40 and above were unaware of HT prior to examination. Male sex [OR 2.32; CI 1.55–3.46], BMI ≥30 kg/m2 [OR 4.10; CI 2.50–6.73], elevated waist-to-hip ratio [WHR; OR 1.57; Cl 1.05–2.34], family history of HT [OR 1.62; Cl 1.12–2.35], and smoking [OR 2.16; CI 1.29–3.61] were significantly associated with increased HT risk. Approximately, 73.0% (95% CI 56.0–86.0) of population attributable fraction for HT was attributed to the measured risk factors. Excessive body mass was associated with 29.0% (95% CI 0.0–58.0) PAFs for HT in participants under 40 and 25% (95% CI 10.0–40.0) in participants over 40. This study demonstrates a considerable burden of HT in a relatively young, urban, and well-educated population. The findings highlight the need for earlier HT detection and targeted health education, particularly focusing on obesity and smoking as key modifiable risks.