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Kunming Bao

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Review Open access Aug 2026

Burden of high blood pressure and associated risk for all-cause and cardiovascular mortality among US young adults.

Background: High blood pressure (BP) in young adults is an underrecognised public health issue with potential long-term health consequences, including increased mortality risk. To examine the prevalence of prehypertension among US young adults and assess its association with all-cause and cardiovascular mortality. Methods: This cohort study utilised data from the National Health and Nutrition Examination Survey (NHANES) 1999-2016. Cox proportional hazards (PHs) regression models were used to estimate hazard ratios (HRs) for mortality. The Fine and Gray subdistribution hazard model was applied to account for competing risks in cardiovascular mortality. Population attributable fractions (PAFs) were calculated to assess the mortality burden associated with prehypertension and hypertension in this population. Prehypertension was defined as a systolic BP (SBP) of 120-139 mm Hg or a diastolic BP (DBP) of 80-89 mm Hg. All-cause and cardiovascular mortality were ascertained through linkage to the National Death Index (NDI) (up to 2019). Results: Among 18,271 participants (mean [SE] age, 28.6 [0.1] years; 49.6% female), the design-weighted prevalence was 23.9% for prehypertension and 14.3% for hypertension. Compared with normotensive individuals, the adjusted HRs for all-cause mortality were 1.82 (95% CI, 1.20-2.74) for prehypertension and 2.39 (95% CI, 1.50-3.81) for hypertension. The HRs for cardiovascular mortality were 1.37 (95% CI, 0.45-4.15) for prehypertension and 4.17 (95% CI, 1.51-11.51) for hypertension. The PAFs for all-cause mortality were 15.1% for individuals with prehypertension and 16.5% for those with hypertension. For cardiovascular mortality, the PAFs were 6.0% for prehypertension and 36.7% for hypertension. Conclusions: In this nationally representative cohort, prehypertension and hypertension were common among US young adults and associated with increased all-cause mortality. These findings highlight the need for early detection and management of high BP in young adults to reduce mortality risk.

M. Ying, Kunming Bao, Dongjun Bao et al. · Blood Pressure · 0 citations

Review Open access Jul 2026

Prevalence and Prognostic Significance of Untreated, Uncontrolled and Resistant Hypertension among American Adults with Prediabetes.

BACKGROUND The prevalence of untreated, uncontrolled and resistant hypertension and their specific prognosis among American adults with prediabetes remain unclear. We aimed to explore the prevalence of hypertension treatment and control and their associated risks of all-cause and cardiovascular disease (CVD) mortality among this population. METHODS We analyzed data from 12,321 participants in the NHANES survey (1999-2016). Prediabetes was defined as fasting plasma glucose 5.6-7.0 mmol/L, hemoglobin A1c 5.7%-6.4%, 2-hour glucose 7.8-11.1 mmol/L, or self-reported diagnosis. Hypertension was defined as blood pressure ≥140/90 mmHg, a self-reported history of hypertension, or current antihypertensive medication use, and categorized into untreated, controlled, uncontrolled, and resistant hypertension. Cox regression assessed associations between hypertension categories and CVD and all-cause mortality. RESULTS The study included 12,321 adults with prediabetes, representing an estimated 53.3 million individuals. Age- and sex-standardized hypertension prevalence was 43%. Among those with hypertension, 62% were receiving treatment. Among treated individuals, 66% had controlled hypertension, 26.5% had uncontrolled hypertension, and 7.5% had resistant hypertension. Mortality risk increased progressively from non-hypertensive to untreated, controlled, uncontrolled, and resistant hypertension stages. Compared to non-hypertensive individuals, hazard ratios (HRs) for CVD mortality were 1.17 (95% CI: 0.80-1.71), 1.52 (1.04-2.21), 2.03 (1.35-3.05), and 1.83 (1.07-3.13), respectively (P trend <0.001). For all-cause mortality, HRs were 1.01 (0.86-1.20), 1.05 (0.87-1.26), 1.16 (0.95-1.41), and 1.42 (1.09-1.85), respectively (P trend = 0.022). CONCLUSIONS Hypertension was highly prevalent among American adults with prediabetes, and mortality risk increased with advancing hypertension stages.

Yong Lin, Kunming Bao, Luojing Zhong et al. · Blood Pressure · 2 citations