Introduction
Hypertension, or high blood pressure, affects more than 122 million adults in the United States—nearly 1 in 2 adults—and over 1.28 billion people globally, according to the World Health Organization and the CDC.
Often called the “silent killer,” it quietly damages blood vessels and organs over time, leading to deadly complications like heart attacks, strokes, kidney failure, and even cancer.
But a new study from Precision Clinical Medicine (Zhou et al., 2025) offers hope. It shows that people with hypertension can significantly reduce—and even eliminate—their increased risk of dying early if they manage a few key risk factors together.
The findings are based on data from the UK Biobank, one of the largest health databases in the world, and offer powerful, actionable insights for anyone living with high blood pressure.
This article breaks down the study’s findings and tells you exactly which lifestyle changes can help you live longer, even with hypertension.
I. Study Basics: Who, What, and How
This research comes from the UK Biobank, a large and long-term health study that has followed over 500,000 volunteers aged 40 to 69 across the United Kingdom since 2006. Participants provided detailed information about their health, lifestyle, and medical history and underwent physical exams and lab tests. Researchers then tracked their health outcomes over time using national health records.
Because of its size, depth, and length of follow-up, the UK Biobank is one of the most respected sources for understanding how lifestyle, genetics, and environmental factors affect the risk of disease and early death.
In this study, researchers selected:
- 70,898 adults with hypertension
- 224,069 matched individuals without hypertension
All were free from cancer and cardiovascular disease at the beginning and were tracked for an average of 16 years (2006–2022).
The goal: to find out if controlling common health risk factors could reduce—or erase—the higher risk of dying early that typically comes with hypertension.
II. What Is Joint Risk Factor Control?
The study measured eight major cardiovascular and metabolic risk factors to determine how well participants were managing their health. Each of these factors has a specific clinical threshold. The more of these a person controlled, the lower their risk of premature death—even if they already had hypertension.
Here’s how the study defined control for each risk factor:
- Blood Pressure Control
- Controlled if:
- Systolic BP < 140 mmHg
- Diastolic BP < 90 mmHg
- This is consistent with common clinical targets for blood pressure management in hypertensive individuals.
- Controlled if:
- Body Mass Index (BMI) Control
- BMI = weight (kg) / height² (m²)
- Controlled if: 18.5 to <25 kg/m²
- This range reflects a normal weight category according to WHO guidelines.
- Waist Circumference Control
- Controlled if:
- ≤ 88 cm (34.6 inches) for women
- ≤ 102 cm (40 inches) for men
- Central obesity strongly predicts metabolic disease, even in people with a normal BMI.
- Controlled if:
- LDL Cholesterol Control (Lipid Control)
- Controlled if: LDL-C < 3.6 mmol/L (approximately <139 mg/dL)
- High LDL cholesterol is a major contributor to atherosclerosis and cardiovascular events.
- Blood Sugar Control (Glycated Hemoglobin / HbA1c)
- Controlled if: HbA1c < 48 mmol/mol (equivalent to <6.5%)
- This is the threshold for avoiding a diabetes diagnosis and its associated risks.
- Albuminuria Control (Kidney Function)
- Albuminuria was assessed by the urinary albumin-to-creatinine ratio (uACR).
- Controlled if: uACR < 3 mg/mmol
- Elevated albumin in urine reflects early kidney damage, commonly seen in both hypertension and diabetes.
- Smoking Control
- Controlled if: Not currently smoking (never or past smoker)
- Smoking cessation remains one of the most powerful interventions for lowering overall mortality risk.
- Physical Activity Control
- Controlled if meeting at least one of the following:
- 150 minutes of moderate intensity activity per week
- 75 minutes of vigorous intensity activity per week
- Or an equivalent combination
- Regular physical activity helps regulate weight, blood pressure, insulin sensitivity, and mental well-being.
- Controlled if meeting at least one of the following:
Together, these eight modifiable risk factors formed the “joint risk factor score.” Controlling more of them was strongly linked to a lower risk of dying early, whether from cardiovascular disease, cancer, or other causes.
Download or print the risk factors below as a daily reminder.
III. Key Findings That Could Save Lives
This study delivers hopeful news: every risk factor you control makes a measurable difference. Even if you already have high blood pressure, you can lower your risk of dying early—one healthy habit at a time.
🔹 What is a “Hazard Ratio” (HR)?
A hazard ratio (HR) is a measure researchers use to compare the risk of an event (like death) happening in one group compared to another.
- An HR of 1.0 means no difference in risk between the two groups.
- An HR less than 1.0 means lower risk.
- For example, an HR of 0.50 means the risk is 50% lower than the comparison group.
In this study, hypertensive people who controlled more health risks had much lower HRs—meaning they were much less likely to die early than those who didn’t.
🔹 Every Additional Risk Factor Controlled Helped:
Compared to hypertensive individuals who didn’t control any risk factors, each additional one that was managed led to:
- 15% lower risk of dying from any cause
- 12% lower risk of dying from cancer
- 24% lower risk of dying from cardiovascular disease (CVD)
- 11% lower risk of dying from other causes
These numbers show a steady drop in risk with every additional healthy behavior.
🔹 Best Outcomes Seen With Six or More Risk Factors Controlled
People who had six or more risk factors under control showed the most dramatic improvements:
- 55% lower risk of dying from any cause (HR: 0.45)
- 50% lower cancer-related death risk (HR: 0.50)
- 67% lower risk of death from cardiovascular disease (HR: 0.33)
- 50% lower risk of dying from other causes (HR: 0.50)
🔹 Hypertension Doesn’t Have to Mean a Shorter Life
Here’s the remarkable part: when hypertensive individuals controlled just a few key risk factors, they lived just as long as people without high blood pressure.
- 3 or more risk factors controlled → no extra risk of early death from any cause
- 2 or more risk factors → no extra risk of cancer or other causes
- 4 or more risk factors → no extra risk of cardiovascular death
This means that with enough effort and the right lifestyle adjustments, people with high blood pressure can match the life expectancy of those without it.
IV. How to Take Action: 8 Risk Factors You Can Control Today
You don’t need to control all eight risk factors overnight. Start with one or two, then build from there. Each step you take brings you closer to eliminating the excess risk from high blood pressure.
Below are the eight key risk factors the study focused on, along with simple ways you can take charge of each one:
1. Blood Pressure
- Target: Keep systolic BP < 140 mmHg and diastolic BP < 90 mmHg.
- How: Limit salt, stay physically active, avoid alcohol, manage stress, and lose weight if needed.
2. Body Mass Index (BMI)
- Target: BMI between 18.5 and 24.9.
- How: Choose nutrient-dense foods, reduce processed carbs and sugary drinks, and increase daily movement.
- Free BMI Calculator: Unlock Your Body’s Health Code Now
3. Waist Circumference
- Target:
- ≤ 88 cm (35 inches) for women
- ≤ 102 cm (40 inches) for men
- Why it matters: Belly fat is more dangerous than fat in other body parts—it raises your risk for diabetes and heart disease.
- What Does Waist Circumference Really Measure?
- How: Reduce added sugars, focus on fiber, and prioritize resistance training.
- To check your waist circumference correctly, stand up straight and place a flexible measuring tape around your bare abdomen, just above the hip bones (iliac crest)—usually in line with your belly button. Ensure the tape is horizontal, snug but not compressing the skin, and measure after a normal exhalation for an accurate reading.
- Intermittent Fasting is a good way to decrease the waistline.
- How to do Intermittent Fasting
4. LDL Cholesterol
- Target: LDL-C < 3.6 mmol/L (about 139 mg/dL)
- How: Eat more omega-3s (flaxseed, fatty fish), reduce saturated fats, and increase fiber.
5. Hemoglobin A1c (HbA1c)
Hemoglobin A1c, or glycated hemoglobin, reflects your average blood sugar levels over the past 2 to 3 months. A level below 48 mmol/mol (6.5%) indicates good blood sugar control and lowers your risk of diabetes-related complications like heart disease, kidney failure, and nerve damage.
- Target: HbA1c < 48 mmol/mol (6.5%)
- How: Control post-meal sugar spikes by walking after meals, avoiding refined carbs, and eating more protein and fiber.
6. Albuminuria (Kidney Function)
Albuminuria is the presence of albumin (a type of protein) in the urine, which signals early kidney damage, especially in people with high blood pressure or diabetes. Detecting and controlling albuminuria can help prevent progression to chronic kidney disease and kidney failure.
- Target: uACR < 3 mg/mmol
- How: Protect your kidneys by keeping blood pressure and blood sugar in check. Avoid NSAIDs unless necessary and stay well-hydrated.
7. Smoking
- Target: Not currently smoking
- How: Seek support, consider nicotine replacements or behavioral therapy, and avoid secondhand smoke exposure.
8. Physical Activity
- Target:
- ≥150 minutes of moderate activity per week, or
- ≥75 minutes of vigorous activity per week, or
- A combination of both
- How: Brisk walking, cycling, swimming, dancing, or resistance training all count.
- You need to see the target heart rate to know if you are doing moderate or vigorous exercise.
- Unlock Your Target Heart Rate Without A Monitor
✅ Small Wins Add Up
Even controlling just 2 to 4 of these risk factors erased the extra risk of death in hypertensive individuals, according to the study. The sooner you start, the more years you can add to your life.
V. Why This Study Matters More Than Ever
Many people living with high blood pressure believe they are bound to suffer a shorter life. But this study challenges that belief and offers a new message: hypertension doesn’t have to lead to early death—if you act.
🔹 A Modern Epidemic With Massive Consequences
Hypertension is no longer just a condition of old age. In fact:
- Nearly 1 in 2 American adults has high blood pressure.
- Worldwide, over 1.28 billion people are affected.
- It silently raises the risk of heart attacks, strokes, kidney failure, and even certain cancers.
The consequences are not just medical—they’re financial and emotional. Chronic disease leads to:
- Endless clinic visits and medications
- Expensive diagnostics and hospitalizations
- Time lost with family, lower quality of life, and financial hardship
🔹 Prevention Is Cheaper and More Effective Than Treatment
This study reinforces a truth that doctors and lifestyle advocates have known for years:
Most of what makes us sick is preventable—and even reversible—through lifestyle changes.
- You don’t need a new drug or an expensive device.
- You don’t need to wait for a miracle cure.
What you need is the decision to act, consistently, on the habits that matter most: controlling your weight, moving daily, quitting smoking, eating better, and managing blood pressure and sugar.
These changes cost less than medical bills, have no side effects, and give back years of life.
🔹 Reaching the Tipping Point for Change
This study is different because it shows that even people who are already diagnosed can wipe out their excess risk—simply by controlling a few major risk factors. You don’t have to be perfect. You just have to get started.
- Control just 2 to 4 factors, and you’re already on the same survival path as someone without hypertension.
- Go for 6 or more, and your risk of early death drops by more than half.
✳️ The Takeaway
Hypertension is not your destiny—it’s your wake-up call.
This study proves that you can rewrite your future with commitment and consistency.
Start with one step. Then another. Because every healthy choice counts.
VI. Final Thoughts: It’s Not Too Late to Start
This groundbreaking study confirms something deeply hopeful:
You can take back control of your health—even with hypertension.
It’s not about being perfect. It’s about progress.
Every single risk factor you manage brings you closer to a longer, healthier life.
- Walking 30 minutes a day counts.
- Quitting smoking counts.
- Choosing water instead of soda counts.
- Keeping your waistline in check counts.
Even controlling just two or three risk factors can erase your excess risk of early death. And if you manage six or more, you could cut your risk in half or more.
💪 Take the First Step Today
- Review the checklist.
- Choose one area to work on this week.
- Share this article with someone you care about who has hypertension.
You don’t have to do everything at once. But you do have to start. Because a longer, stronger life is waiting on the other side of your effort.
Don’t Get Sick!
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Reference:
Jian Zhou, Minghao Kou, Rui Tang, Xuan Wang, Hao Ma, Xiang Li, Yoriko Heianza, Lu Qi, Degree of joint risk factor control and premature mortality in hypertensive participants, Precision Clinical Medicine, Volume 8, Issue 2, June 2025, pbaf006, https://doi.org/10.1093/pcmedi/pbaf006
Image credits:
- Hypertension complications By Mikael Häggström, used with permission. – All used images are in the public domain., Public Domain, https://commons.wikimedia.org/w/index.php?curid=5678966
- Waist hip ratio By The RedBurn, from original works by Mikael Häggström, SuicideGirls and FatM1ke – Original image: Waist-hip ratio.svg, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=72156117
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