Nearly half of U.S. adults experience high blood pressure, recognized as a primary risk factor for heart disease, strokes, heart attacks, heart failure, kidney issues, and even cognitive decline.
Recently, the American Heart Association (AHA) and the American College of Cardiology updated their guidelines for managing high blood pressure for the first time since 2017.
“The 2025 updates represent a new body of evidence that offers better opportunities for longer and healthier lives,” noted Daniel W. Jones, MD, dean and professor emeritus of the University of Mississippi Medical Center School of Medicine and chair of the guideline writing committee.
Blood Pressure Measures Remain the Same in New Guidelines
The thresholds for normal, elevated, and high blood pressure, determined via a blood pressure cuff, have not changed:
- Normal blood pressure is defined as below 120/80 mm Hg
- Elevated blood pressure ranges from 120-129/80 mm Hg
- High blood pressure is at 130/80 mm Hg or greater
For those with high blood pressure, consider these six essential takeaways from the new guidelines:
1. Get on Medications Sooner
The updated guidelines suggest that healthcare providers should prescribe medications for high blood pressure more promptly, especially if lifestyle changes in the first three to six months do not yield improvements.
One compelling reason for this timely approach, according to Jones, is that research has reaffirmed that high blood pressure can also contribute to cognitive decline.
Even after starting on blood pressure medications, healthcare providers will continue to advocate for beneficial practices like exercising regularly and maintaining a balanced diet, shared Scott Jerome, MD, director of Ambulatory Services and Outreach for Cardiovascular Medicine at the University of Maryland School of Medicine.
2. Lower Your Salt Intake Even Further
Similar to the previous guidelines, the update still recommends limiting sodium intake to below 2,300 mg daily (approximately one teaspoon of salt) and aiming for a target of no more than 1,500 mg daily.
The AHA advises scrutinizing food labels since most dietary sodium consumed by U.S. adults comes from packaged and restaurant foods. Many dining establishments list sodium content online, and you can request options with reduced salt or ask for sauces to be served on the side.
When preparing meals at home, consider using potassium-rich salt substitutes and incorporating more potassium-rich foods like bananas, spinach, mushrooms, and honeydew melon.
3. Try to Quit or Limit Alcohol
The new guidelines recommend complete abstinence from alcohol. For those who choose to drink, the guidance is to limit consumption to no more than two drinks per day for men and one drink per day for women.
A 2023 review of several studies published in Hypertension found that each additional alcoholic beverage can raise blood pressure over time, even in individuals who do not currently exhibit high blood pressure.
4. Manage Stress
Stress is known to be linked to heart disease. The guidelines suggest exploring stress-management strategies such as yoga, deep breathing exercises, and meditation.
The update also continues to recommend that adults engage in at least 75–150 minutes of physical activity weekly, which encompasses aerobic exercises like brisk walking along with strength training using bands or weights.
5. Lose at Least 5% of Body Weight
The newest guidelines recommend that adults with overweight or obesity aim to shed a minimum of 5% of their body weight. Consult with your healthcare provider about dietary changes, weight-loss medications like Wegovy or Zepbound, or surgical options for weight reduction.
6. Adopt the DASH Diet
The 2025 guidelines continue to emphasize healthy eating, particularly endorsing the DASH diet, which prioritizes reduced salt intake and increased consumption of vegetables, whole grains, legumes, nuts, seeds, low- or non-fat dairy, poultry, and fish.
Know Your Blood Pressure Numbers
Understanding your blood pressure numbers is crucial for reaping the benefits of these updated guidelines. Unfortunately, many people are unaware of their own levels, according to Allen Taylor, MD, chair of Cardiology at MedStar Heart and Vascular Institute in Washington, DC.
Taylor advises that keeping a blood pressure cuff at home, sharing your numbers during healthcare visits, and reporting any changes will help determine if lifestyle or medication adjustments are necessary.
