Ten Things to Pay Attention to in the New Blood Pressure Guidelines

Kahn Center for Cardiac Longevity Blog Ten Things to Pay Attention to in the New Blood Pressure Guidelines

 

 

Preventing and managing high blood pressure with healthy lifestyle behaviors, such as following a heart-healthy diet including reducing salt intake, staying physically active, maintaining a healthy weight and managing stress—combined with early treatment with medication to lower blood pressure if necessary—are recommended to reduce the risk of heart attack, stroke, heart failure, kidney disease, cognitive decline and dementia, according to a new clinical guideline published in the American Heart Association's peer-reviewed journals Circulation and Hypertension, and in JACC, the flagship journal of the American College of Cardiology.

The "2025 AHA / ACC Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults" replaces the 2017 guideline and includes new or updated recommendations for blood pressure management based on the latest scientific evidence to achieve the best health outcomes for patients.

    1. There is stronger proof now that high blood pressure is linked to increased risk of cognitive decline and dementia. If you have high blood pressure, lowering it now may help protect your brain health in the future.
    2. High blood pressure is the leading risk factor for stroke and a number of heart conditions such as coronary artery disease, heart failure and atrial fibrillation (AFib).
    3. During or after pregnancy, you can develop high blood pressure, including a dangerous condition called preeclampsia. Checking blood pressure before, during and after pregnancy helps you and your health care team stay on top of your health. Talk to your health care professional about treatment options.

New: Blood Pressure Categories During Pregnancy

 
BLOOD PRESSURE CATEGORY SYSTOLIC mm Hg (top/upper number) and/or DIASTOLIC mm Hg (bottom/lower number)
NON-HYPERTENSIVE LESS THAN 140 and LESS THAN 90
HYPERTENSION IN PREGNANCY* 140 OR HIGHER or 90 or higher
SEVERE HYPERTENSION*
(If you don’t have symptoms, call your health care professional immediately)		 160 OR HIGHER or 110 OR HIGHER
* If you have any of these symptoms, call 911: severe headache, change in vision, abdominal pain, chest pain, significant swelling, or shortness of breath

4. Know your numbers: Normal blood pressure is when:

  • Systolic pressure (top number) is less than 120 and
  • Diastolic pressure (bottom number) is less than 80

If your blood pressure is higher, talk to your health care professional about how to lower it.

If your systolic is higher than 180 and/or your diastolic is higher than 120, it could be life-threatening. Call 911 right away if you have any of these symptoms:

  • Chest pain
  • Shortness of breath
  • Back pain
  • Numbness
  • Weakness
  • Change in vision
  • Difficulty speaking

Blood Pressure Categories

 
BLOOD PRESSURE CATEGORY SYSTOLIC mm Hg (top/upper number) and/or DIASTOLIC mm Hg (bottom/lower number)
NORMAL LESS THAN 120 and LESS THAN 80
ELEVATED 120 – 129 and LESS THAN 80
STAGE 1 HYPERTENSION (High Blood Pressure) 130 – 139 or 80 – 89
STAGE 2 HYPERTENSION (High Blood Pressure) 140 OR HIGHER or 90 OR HIGHER
SEVERE HYPERTENSION (If you don’t have symptoms*, call your health care professional) HIGHER THAN 180 and/or HIGHER THAN 120
HYPERTENSIVE EMERGENCY (If you have any of these symptoms*, call 911) HIGHER THAN 180 and/or HIGHER THAN 120
*symptoms: chest pain, shortness of breath, back pain, numbness, weakness, change in vision, or difficulty speaking

5. Anyone can develop high blood pressure. People are encouraged to have their blood pressure checked regularly. This includes people in all age groups: children, young adults, adults and older adults.

6. To get the best blood pressure reading, sit in a chair with support for your back, both feet flat on the ground, arm extended and supported at heart level, stay quiet and still. Find out how to check your blood pressure the right way.

7. In addition to lifestyle changes, you may need medication. Learn more about the different types of high blood pressure medications.

8. Eating a healthy diet can help lower or prevent high blood pressure. Some key nutrition information to know:

    • Sodium (Salt) – Adults should have 2,300 mg (about 1 teaspoon of salt) of sodium a day or less, moving toward an ideal limit of less than 1,500 mg (about 2/3 teaspoon of salt). Follow a heart healthy eating pattern, for example the DASH eating plan, which emphasizes reduced sodium intake and a diet high in vegetables, fruits, whole grains, legumes, nuts and seeds, and low-fat or nonfat dairy, and includes lean meats and poultry, fish and cooking with non-tropical oils.
    • Fruits and Vegetables – Eat plenty of fruits and vegetables, emphasize variety.
    • Alcohol – Drink less or no alcohol to lower or prevent high blood pressure.
    •  
    • 9. If you are overweight or obese, losing at least 5% of your body weight can help lower or prevent high blood pressure. Here’s an example. If someone weighs 180 pounds, they could look up: what is 5% of 180. The answer is 9. Losing 9 pounds can help lower their blood pressure
    •  
    • 10. Check out Life’s Essential 8 to learn more about what you can do to improve your heart and brain health. To help manage blood pressure, eat smart with a DASH-style eating pattern, stay active your way, reduce or eliminate alcohol, and try stress-reducing activities, including meditation, breathing control and/or yoga. It’s also important to ask your health care professional about other common health conditions that can lead to high blood pressure, which include conditions such as overweight, sleep apnea, diabetes and thyroid problems.
Author
Dr. Joel Kahn

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