New Blood Pressure Guidelines 2025 are Out: What’s New?

8.22.2025 0 comments

Author: Trisha Houghton, CNS, ASIST

A new set of clinical guidelines for diagnosing and managing has been released by the American College of Cardiology (ACC) and the American Heart Association (AHA). The report, published on August 14th, 2025, in Journal of the American College of Cardiology (JACC), introduces brand-new recommendations for blood pressure screening, treatment strategies, and risk assessment tools.

The new guidelines, developed by the AHA/ACC Joint Committee, with collaboration and endorsement from 11 additional professional organizations aim to reduce cardiovascular disease (CVD), kidney damage, and cognitive decline in the population.

Read the full report here: https://www.jacc.org/doi/10.1016/j.jacc.2025.05.007

What the 2025 Guideline Changes Include

The new recommendations for 2025 cover a very wide range of updates – from diagnostic improvements, revised recommendations, all the way to medication strategies and risk assessment.

Key changes in the new blood pressure guidelines include:

• New risk assessment tool: The report introduces PREVENT, also known as Predicting Risk of CVD EVENTs. It’s a personalized risk calculator that uses measures of cardiovascular, kidney, and metabolic health. It also incorporates social determinants of health such as location.
• Universal kidney screening: To detect early kidney damage, a urine albumin-to-creatinine test is now being recommended for all adults diagnosed with hypertension.
• Expanded screening for hormonal root causes: Testing for primary aldosteronism – a treatable cause of high blood pressure – is now advised for more patients. These recommendations include people dealing with resistant hypertension, as well as with stage 2 hypertension, to improve detection.
• Acknowledgement of GLP-1 receptor antagonists: For adults with obesity and hypertension, glucagon-like peptide-1 drugs may be considered as part of the treatment due to slowing decline in kidney function and having some beneficial effects on blood pressure.
• Treatment adjustments for stage 2 hypertension: Patients with stage 2 hypertension (140/90 mm Hg or above) should begin therapy with two medications, ideally in a single combination pill.
• Pregnancy management: Chronic hypertensions in women who are planning to get pregnant or who become pregnant should now be treated at 140/90 mm Hg or above, and low-dose aspirin is recommended to lower preeclampsia risk.
• Focus on cognitive health: The report reinforces the need for protecting against small-vessel brain damage and reducing dementia risk by controlling systolic blood pressure below 130 mm Hg.

Together, these new updates and recommendations highlight the importance of early diagnosis, individualized treatment, and paying more attention to health issues that often go under the radar – such as hormonal imbalances and kidney disease.

Lifestyle Recommendations for Heart Health Still Remain Key

While the new guidelines heavily discuss medications and screening tools, healthy lifestyle modifications still remain as the foundation of managing blood pressure.

The updated report emphasizes several proven strategies, which have been long used in the world of functional medicine:

• Weight loss: A 5% body weight reduction is recommended for overweight and obese adults to help with prevention and treatment of elevated blood pressure and hypertension.
• Sodium intake: For adults with or without hypertension, lowering sodium intake to below 2,300 mg/day – or ideally 1,500 mg/day is still an ideal goal for even better benefit to promote normal blood pressure.
• Nutrient-rich diet: Dietary approaches to stop hypertension (such as eating a wide variety of vegetables and low glycemic fruits, whole grains, and legumes) are considered a heart-healthy eating pattern.
• Alcohol consumption: It’s now advised to limit alcohol to less than 2 drinks a day for men and less than 1 for women, however for the best reduction of risk, abstinence is recommended.
• Physical activity: Daily movement and engaging in 150 minutes/week of exercise programs like aerobic exercise and resistance training is recommended as a healthy lifestyle behavior that can prevent hypertension.
• Stress management: Relaxing techniques such as breath work, yoga and meditation, are all listed as reasonable techniques that should go along other lifestyle or medication interventions for managing blood pressure.

All of the lifestyle measures above are critical in not just managing elevated blood pressure or hypertension, but also for preventing these cardiovascular issues in the first place.

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Why the New Blood Pressure Guidelines Matter

With nearly 47% of American adults having blood pressure above 130/80 mm Hg, it’s safe to say that the higher risk for heart attacks, strokes, kidney diseases, and even dementia is affecting a large part of the population.

The report by ACC, AHA, endorsed by 11 additional medical organizations puts emphasis on early prevention, risk assessment, and more precise screening tools – educating people on how to make a healthy shift before cardiovascular problems appear.

This guideline is designed as the most up-to-date document, and will be revised as new evidence and scientific research keeps emerging. In the near future, we may be able to expect more recommendations on digital health tools, wearable monitors, and precise therapies that combine medications with lifestyle components.

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