For the first time since 2017, the American Heart Association (AHA) and the American College of Cardiology (ACC) have updated their joint guidelines for managing high blood pressure. These changes, released in 2025, aim to offer a more individualized, long-term approach to help people reduce their risk of serious health problems like heart disease, stroke, kidney damage, and even dementia.
Overview
High blood pressure, or hypertension, affects millions of adults in the U.S., and it’s often called the “silent killer” because it usually doesn’t show symptoms until damage is already done. With this new set of guidelines, health experts want to catch risks earlier, offer more treatment options, and protect long-term brain and heart health.
According to Dr. Daniel W. Jones, chair of the committee behind the update, the goal is to provide more tools for doctors to help their patients stay ahead of chronic conditions by managing blood pressure over a lifetime.
GLP1
One of the biggest updates involves GLP-1 medications—drugs like Ozempic and Mounjaro that have become widely known for aiding weight loss. These medications, originally developed for Type 2 diabetes, have shown benefits in lowering blood pressure in people who are overweight.
The 2025 guidelines now suggest that patients with high blood pressure and excess weight might benefit from being prescribed a GLP-1. This marks the first time such weight loss medications have been included in blood pressure recommendations. It’s a step toward integrating metabolic health and blood pressure treatment more closely.
Pregnancy
There’s also a shift in guidance for pregnant and postpartum individuals. The updated recommendations now say that those who show stage 2 hypertension (readings of 140/90 mm Hg or higher) during pregnancy or after delivery should be prescribed medication.
This change follows growing evidence that high blood pressure during pregnancy can lead to serious complications such as preeclampsia, which can be dangerous for both mother and baby. Treating high blood pressure early in these cases could prevent long-term damage.
Dementia
Another important addition in the 2025 guidelines is a new emphasis on how high blood pressure affects brain health. Research shows that hypertension can interfere with blood flow to the brain, contributing to cognitive decline and increasing the risk of developing dementia.
This finding has added urgency to treating high blood pressure—not just to protect the heart, but also to preserve memory and mental clarity as people age.
Calculator
To better estimate each patient’s risk, the AHA has introduced a new tool called the PREVENT calculator. This tool helps doctors predict a person’s risk of developing cardiovascular disease within both 10 and 30 years.
PREVENT considers key health factors including age, sex, cholesterol levels, and of course, blood pressure. By using this kind of risk calculator, doctors can make more personalized treatment plans rather than taking a one-size-fits-all approach.
Numbers
While the approach to treatment has changed, the definition of high blood pressure remains the same as it was in the 2017 guidelines. Here’s a refresher:
| Blood Pressure Category | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Normal | Less than 120 | and less than 80 |
| Elevated | 120–129 | and less than 80 |
| Stage 1 Hypertension | 130–139 | or 80–89 |
| Stage 2 Hypertension | 140 or higher | or 90 or higher |
These benchmarks are still the gold standard for diagnosing and monitoring high blood pressure.
Lifestyle
Of course, medications are not the only answer. The updated guidelines still stress the importance of healthy lifestyle habits. Regular exercise, reducing sodium intake, eating a balanced diet, and managing stress all continue to be key strategies for preventing and managing high blood pressure.
By making changes early and staying consistent, many people can avoid or delay the need for medication entirely.
The 2025 update is a reminder that health isn’t one-size-fits-all. With tools like the PREVENT calculator and newer treatments like GLP-1s, there’s more support than ever to help people take control of their blood pressure and overall well-being.
FAQs
What is the PREVENT risk calculator?
A tool to estimate 10- and 30-year cardiovascular risk.
Are GLP-1 drugs now recommended?
Yes, for overweight patients with high blood pressure.
Do guidelines change for pregnant women?
Yes, meds are advised for stage 2 hypertension.
Does blood pressure affect brain health?
Yes, it can increase risk of dementia and memory loss.
Are the BP categories still the same?
Yes, definitions from 2017 remain unchanged.
