Revised American Heart Association guidelines on hypertension
The American Heart Association (AHA) has revised its guidelines on hypertension. Hypertension affects approximately one in every three adults worldwide. It is a risk factor for several health conditions, including heart attack, stroke, heart failure and kidney damage. The new blood pressure guidelines feature several changes that highlight earlier assessment and intervention for elevated blood pressure. They emphasise the importance of lifestyle modifications to help control blood pressure, such as reducing sodium and intake of alcoholic beverages, following a heart-healthy diet, staying physically active, and managing weight and stress. To update their guidelines, the AHA conducted a thorough review of clinical studies, reviews, and other evidence related to hypertension published since February 2015.
The key updates for 2025 include:
- The goal of achieving a systolic blood pressure of 130 mmHg or below, and ideally 120 mmHg, for adults with high blood pressure;
- More clear and robust evidence that intensive blood pressure lowering reduces the risk of cognitive decline and dementia;
- In adults with an average blood pressure of 130/80 mm Hg or higher and a 10-year cardiovascular disease risk of less than 7.5% as determined by the PREVENT risk calculator, initiation of medication to lower blood pressure alongside lifestyle modifications is recommended if, after an initial 3- to 6-month trial of lifestyle changes only, the blood pressure remains at 130/80 mm Hg or higher;
- Recommendations to move towards an ideal limit of 1500 mg/day [milligrams per day] for sodium intake; and
- Advice to stop consuming, or at least to reduce consumption of alcoholic beverages to less than 1 drink per day for women and less than 2 drinks per day for men (1 drink = 14 g of alcohol), to prevent or treat elevated blood pressure hypertension.
The full report is available in: Hypertension August 2025: 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines