New Blood Pressure Guidelines Mean You May Now Have Hypertension

According to recent data, approximately 50% of all Americans are affected by high blood pressure, a condition medically known as hypertension.

Hypertension is the leading risk factor for heart disease and strokes, and it has also been linked to dementia. Notably, these conditions are among the top causes of death in the United States, with heart disease, stroke, and dementia ranked first, fourth, and sixth, respectively.

Disturbingly, only 25% of individuals with high blood pressure have it under control.

Related: New Guidelines for High Blood Pressure: Implications and Insights.

In August 2025, the American Heart Association and the American College of Cardiology unveiled updated recommendations for the prevention and management of hypertension, drawing from an extensive review of research conducted over the last decade.

Key Highlights from the Updated Guidelines

The guidelines released in 2025 mark a significant shift from their previous iteration in 2017. Since the last guidelines, medical research has yielded new insights into hypertension management.

A primary change is in the definition of hypertension; the criteria have become more stringent and target blood pressure numbers are now lower than before.

The criteria rely on values of systolic and diastolic pressure. Systolic pressure represents the force exerted on arteries when the heart beats, while diastolic pressure indicates the pressure in the arteries when the heart rests between beats.

Notably, the latest guidelines have eliminated the category of “prehypertension,” previously defined by systolic values of 120-139 mm Hg and diastolic values of 80-99 mm Hg. Instead, blood pressure readings of 120-129/<80 mm Hg are categorized as “elevated,” while 130-139/80-89 mm Hg signifies stage 1 hypertension. Readings of 140/90 mm Hg or greater are classified as stage 2 hypertension, while 180/120 mm Hg or above represents a hypertensive crisis. This significant change may affect millions of individuals in the U.S.

Patients are encouraged to discuss these new criteria with their healthcare providers and explore treatment options. Lifestyle modifications—such as improved diet, increased physical activity, and enhanced sleep habits—are also crucial for managing blood pressure levels.

Furthermore, the guidelines recommend utilizing a risk calculator known as PREVENT, which stands for Predicting Risk of Cardiovascular Disease EVENTS, to better assess an individual’s overall risk of cardiovascular disease and heart failure.

The Interplay Between Alcohol Consumption and Hypertension

In light of the new standards, there’s a strong recommendation to limit alcohol intake due to its association with elevated blood pressure. A recent meta-analysis involving nearly 20,000 participants indicated that systolic blood pressure rises approximately 1 mm Hg for every 10 grams of alcohol consumed.

A typical beer contains around 14 grams of alcohol, meaning habitual drinking can lead to a gradual increase in blood pressure. However, research suggests that individuals who reduce or cease excessive alcohol consumption may see a drop in their blood pressure levels.

While the increments may seem minimal, they can compound with other negative lifestyle factors, such as sedentary habits, poor sleep, obesity, psychological stress, and smoking, amplifying the risks associated with heart disease, stroke, and dementia.

The new guidelines advise limiting alcohol to a maximum of two drinks per day for men and one drink per day for women to mitigate these risks.

Dietary Recommendations to Combat Hypertension

In addition to addressing alcohol consumption, the new guidelines place considerable emphasis on dietary habits affecting blood pressure. They recommend that adults—irrespective of hypertension status—should limit salt intake to under 2,300 mg per day, ideally targeting less than 1,500 mg daily.

For context, the average American consumes over 3,300 mg of salt daily. Substituting sodium with potassium-based alternatives may be beneficial in lowering blood pressure.

The guidelines advocate for the DASH diet (Dietary Approaches to Stop Hypertension), suitable for all adults, which emphasizes the intake of fruits, vegetables, whole grains, and low-fat or nonfat dairy products. Following this meal plan can potentially lead to significant reductions in blood pressure.

Main Preventive Strategies Highlighted

The PREVENT risk calculator, which the guidelines highly recommend, factors in various parameters including demographics, medical history, cholesterol levels, and current blood pressure to assess an individual’s risk profile. This free online tool helps tailor health care approaches, especially for those managing chronic conditions such as hypertension and diabetes.

Additionally, the American Heart Association outlines eight essential health behaviors designed to lower blood pressure and decrease cardiovascular disease risk, encompassing aspects like a healthy diet, regular physical activity, smoking cessation, adequate sleep, and weight control.

Changes in Hypertension Management Practices for Healthcare Professionals

One of the most exciting advancements in these guidelines is the focus on personalized healthcare through the PREVENT calculator, promoting tailored treatment plans based on individual patient profiles.

Healthcare providers are encouraged to empower patients by facilitating home monitoring of blood pressure to gain insight into daily fluctuations.

Moreover, the guidelines advocate for a more proactive stance in addressing and treating high blood pressure, which remains a primary contributor to heart disease and stroke.

William Cornwell, Associate Professor of Cardiology, University of Colorado Anschutz Medical Campus

This article is adapted from The Conversation under a Creative Commons license. Access the original article here.