AHA & ACC Release New Guidelines for High Blood Pressure to Reduce CVD Risk

The American Heart Association and the American College of Cardiology have released a joint guideline suggesting earlier treatment for high blood pressure to reduce cardiovascular disease (CVD) risk.

Titled the “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,” this new release replaces the 2017 guideline, providing updated or new recommendations for blood pressure management. The collective organizations encourage physical activity, heart-healthy diets, and stress management to reduce the risk of heart attack, stroke, kidney disease, cognitive decline and dementia, and heart failure.¹

“High blood pressure is the most common and most modifiable risk factor for heart disease,” said Daniel Jones, MD, dean and professor emeritus of the University of Mississippi School of Medicine and Chair of the guideline writing committee. “By addressing individual risks earlier and offering more tailored strategies across the lifespan, the 2025 guideline aims to aid clinicians in helping more people manage their blood pressure and reduce the toll of heart disease, kidney disease, type 2 diabetes, and dementia.”¹

The comprehensive list includes a table detailing new additions, such as suggesting adults with hypertension get regularly screened for primary aldosteronism, utilize potassium-based salt substitutes to prevent elevated blood pressure, and maintain <130 mm Hg systolic blood pressure to avoid mild cognitive impairment. Each of these recommendations was drafted after a literature search from December 2023 to June 2024, identifying clinical studies, reviews, and other evidence published since 2015.²

Key guidelines include the following:

• Limiting sodium intake to <2,300 mg per day (with an ideal goal of 1,500 mg per day)
• Consuming no alcohol (or for those who choose to drink, no more than 2 drinks per day for men and 1 per day for women)
• Managing stress with exercise and stress-reduction techniques like meditation or yoga
• Maintaining a healthy weight, with ≥5% reduction in body weight in adults with obesity or overweight
• Following a heart-healthy diet, like the DASH plan
• Engaging in physical activity of ≥75-150 minutes weekly, including aerobics and/or resistance training
• Home blood pressure monitoring to help confirm office diagnoses and to track progress¹

Notably, the guideline also highlights the potential risks of high blood pressure during pregnancy. Chronic pre- and postpartum hypertension, as well as preeclampsia and eclampsia, are indicated as potential risks, and clinicians are encouraged to recommend aspirin and other medications should systolic blood pressure reach ≥140 mm Hg and/or diastolic blood pressure reach≥90 mm Hg.¹

The new guidelines also recommend that health care professionals utilize the Predicting Risk of CVD EVENTs (PREVENT) risk calculator, which were derived from contemporary data, including a more diverse sample of racial and ethnic groups compared to the traditional pooled cohort equations (PCEs). PREVENT also expands investigatory scope to total CVD risk, including myocardial infarction, stroke, and heart failure, compared to the PCEs’ measurement of solely atherosclerotic cardiovascular disease.²

Additionally, clinicians are recommended to use the ratio of urine albumin and creatinine for all patients with high blood pressure, rather than viewing it as optional. The plasma aldosterone-to-renin ratio test has also had its indication expanded as a screening tool.¹

“This updated guideline is designed to support health care professionals—from primary care teams to specialists, and to all clinicians across health systems—with the diagnosis and care of people with high blood pressure,” Jones said. “It also empowers patients with practical tools that can support their individual health needs as they manage their blood pressure, whether through lifestyle changes, medications, or both.”¹

References

1. American Heart Association. New high blood pressure guideline emphasizes prevention, early treatment to reduce CVD risk. Eurekalert! August 14, 2025. Accessed August 14, 2025. https://www.eurekalert.org/news-releases/1094543

2. Jones D, Ferdinand K, Taler S. et al. 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. JACC. null2025, 0 (0). https://doi.org/10.1016/j.jacc.2025.05.007