Four out of five American adults with high blood pressure don’t have their condition under control, putting them at increased risk for heart disease and dementia, a new study says.

About 79% of people with high blood pressure have failed to get it down to a healthier level, according to findings published in the Journal of the American Medical Association.

Worse, three out of five (61%) people with uncontrolled blood pressure aren’t bothering to take medication that might help lower it, researchers found.

That matters because about two-thirds of those not taking medication have blood pressure only 10 points above their healthy goal, "indicating that many could potentially achieve blood pressure control with initiation of antihypertensive medication and lifestyle modification," wrote the research team led by Shakia Hardy, an associate professor of epidemiology at the University of North Carolina at Chapel Hill.

"My key takeaways from the study are that there are many people who are not being adequately treated for high blood pressure, and there are certainly many opportunities to be able to treat them, as the study demonstrated," said Dr. Benjamin Hirsh, director of preventive cardiology at the Sandra Atlas Bass Heart Hospital at Northwell Health in Manhasset, New York.

For the new study, researchers used federal health survey data collected between 2021 and 2023 to analyze more than 3,200 people with high blood pressure.

The team specifically looked at people whose blood pressure was lower than 130 systolic and 80 diastolic, which is the treatment goal set by the American Heart Association and the American College of Cardiology.

Results showed that a lack of access to health care is not the reason why most people have uncontrolled high blood pressure.

"More than 80% of U.S. adults with uncontrolled blood pressure had health insurance and reported having a routine place for care," researchers wrote.

Hirsh, who was not involved in the study, said getting high blood pressure under control can pay huge health dividends.

"The ramifications for not having blood pressure under control include on a long-term basis, and even sometimes on a short-term basis, stroke, heart attacks, damage to other organs such as the kidneys," Hirsh said.

"Clearly, the vast majority of patients really need to have optimization of their blood pressure, and there’s a big gap in blood pressure management that is not being addressed," he said. "This can portend negative adverse health effects for these patients who are undertreated."

Blood pressure medications aren’t the only tool in a person’s arsenal, Hirsh said.

"First and foremost, you always want to start with simple things such as salt reduction," he said. "Salt is actually very powerful. People underestimate how powerful it can be in raising blood pressure."

Even a little salt can be potent.

"A lot of people are salt sensitive, meaning that their blood pressure rises significantly in response to even low salt loads," Hirsh said. "So really pay attention to not just what you put on your food, but also what’s in the food."

Hirsh also recommends that folks keep close tabs on their blood pressure.

"Have a good blood pressure monitor," he urged. "There are some very reliable ones that you can get very inexpensively at most pharmacies. Just monitoring and keeping a journal of what your blood pressures are throughout the day is really helpful."

Publication details

Shakia T. Hardy et al, Blood Pressure Above Goal Among US Adults With Hypertension, JAMA (2026). DOI: 10.1001/jama.2025.25657

Journal information: Journal of the American Medical Association

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Citation: High blood pressure uncontrolled in 4 out of 5 Americans (2026, February 3) retrieved 3 February 2026 from https://medicalxpress.com/news/2026-02-high-blood-pressure-uncontrolled-americans.html

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