More Americans Now Meet the Criteria for High Blood Pressure Under New Guidelines

Nearly half of all Americans are now classified as having high blood pressure, a condition medically known as hypertension, following recent updates to the official guidelines. Hypertension remains the leading risk factor for heart disease and stroke, which are among the top causes of death in the United States. Additionally, unmanaged high blood pressure increases the risk of developing dementia and experiencing cognitive decline. Unfortunately, only 1 in 4 individuals with a history of hypertension manage to keep their condition under control.

In August 2025, the American Heart Association and the American College of Cardiology issued new guidelines for the prevention and management of hypertension. These guidelines are based on a comprehensive review of scientific literature from the past decade and aim to improve diagnosis, treatment, and prevention strategies. Cardiologist Dr. William Cornwell from the University of Colorado explains that these new recommendations have shifted the definition of high blood pressure, with more stringent criteria and lower target blood pressures.

The updated classification removes the previous 'prehypertension' category. Instead, blood pressure readings are now categorized as 'elevated' if they are between 120–129 mm Hg systolic and less than 80 mm Hg diastolic, and 'stage 1 hypertension' for measurements between 130–139 mm Hg systolic or 80–89 mm Hg diastolic. Readings of 140/90 mm Hg or higher are classified as stage 2 hypertension, while a crisis occurs at 180/120 mm Hg or above. These changes may significantly impact millions of Americans, prompting individuals to consult their healthcare providers about their blood pressure status under the new criteria.

The guidelines also emphasize lifestyle modifications, such as diet, exercise, and sleep habits, to help control blood pressure. Healthcare providers are encouraged to use risk assessment tools like PREVENT, which calculates a patient's overall cardiovascular risk based on various individual factors, facilitating a personalized approach to care.

An important aspect of the guidelines is addressing alcohol consumption. Evidence shows that alcohol intake can raise systolic blood pressure by approximately 1 mm Hg for every 10 grams of alcohol consumed. Since a standard beer contains about 14 grams of alcohol, regular drinking can elevate blood pressure over time. The new recommendations advise limiting alcohol intake—no more than two drinks per day for men and one for women—or complete abstinence.

Diet and physical activity are also crucial. The guidelines recommend reducing salt intake to less than 2,300 milligrams daily, with an ideal goal of under 1,500 milligrams. The Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, low-fat dairy, and whole grains, can lower blood pressure by up to 10 mm Hg. Furthermore, increased aerobic exercise, particularly accumulating 150 minutes per week, can decrease systolic blood pressure by approximately 2 mm Hg, contributing to overall cardiovascular health.

Preventive strategies include using the PREVENT risk calculator, which considers factors like demographics, cholesterol, and medical history to gauge individual cardiovascular risk. The American Heart Association also highlights eight core health behaviors—healthy diet, regular exercise, smoking cessation, adequate sleep, and weight, cholesterol, blood sugar, and blood pressure management—as vital for cardiovascular health.

The new guidelines also promote more personalized medical care, encouraging patients to monitor blood pressure at home and physicians to adopt a more aggressive approach in treating hypertension to prevent long-term complications like heart disease and stroke. Overall, these updates aim to better identify at-risk individuals and implement effective lifestyle and medical interventions to improve public health outcomes.