Prevalence of Undiagnosed Hypertension in Young Adults: A Community-Based Study

Background Undiagnosed hypertension among young adults is a growing public health concern, contributing silently to long-term cardiovascular morbidity. This study aimed to determine the prevalence of undiagnosed hypertension (Stage 1-2, previously unrecognized) and to assess statistically significant associations with lifestyle risk factors in a community-based young adult population. Methods A community-based, cross-sectional study was conducted at Hazrat Bari Sarkar (HBS) Medical and Dental College, Islamabad, Pakistan, from January to December 2023. Using non-probability convenience sampling, 263 adults aged 18-35 years were recruited. The sample size was calculated based on an estimated 22% prevalence, a 95% confidence level, and a 5% margin of error. Data were collected using a structured questionnaire and standardized blood pressure (BP) measurements. BP was measured twice, five minutes apart, in the morning, after the participant was seated and rested for at least five minutes. BP was categorized using the 2017 ACC/AHA guidelines. Data were analyzed with IBM SPSS Statistics for Windows, Version 26 (released 2019; IBM Corp., Armonk, NY, USA), using Chi-square tests; p < 0.05 was considered significant. Prevalence estimates are reported with 95% confidence intervals (CIs). Results The prevalence of undiagnosed hypertension (Stage 1-2, previously undiagnosed) was 14.83% (95% CI: 10.8%-19.7%), while 14.07% (95% CI: 10.1%-18.9%) had elevated BP (pre-hypertensive range). Undiagnosed hypertension was significantly associated with age 25-30 years (p = 0.011), a sedentary lifestyle (p = 0.001), high salt intake (p = 0.018), obesity (p = 0.041), and smoking (p = 0.026). Although more females than males had undiagnosed hypertension (22 vs. 17 cases), this difference was not statistically significant (p = 0.076). Conclusion Undiagnosed hypertension is prevalent among young adults and significantly associated with modifiable lifestyle factors. Given the limitations of convenience sampling and the specific college-based setting, the findings may not fully generalize to all young adults. Future studies should use stratified or cluster sampling to improve representativeness. Early, targeted screening and lifestyle interventions are warranted in this population.