Hypertension
New hypertension guideline calls for earlier treatment and team-based care
The 2025 AHA/ACC guideline, developed in collaboration with 12 other medical organizations, positions hypertension as the leading modifiable risk factor for cardiovascular disease, stroke, kidney disease, dementia, and all-cause mortality. It sets a universal treatment goal of <130/80 mm Hg for all adults, with tailored considerations for older adults, pregnant individuals, and those in institutional care.
Key updates include earlier initiation of antihypertensive therapy for patients with blood pressure ≥130/80 mm Hg and elevated cardiovascular risk (≥7.5% 10-year risk per the PREVENT calculator). For stage 2 hypertension (≥140/90 mm Hg), dual therapy with two first-line agents in a single-pill combination is preferred to improve adherence and accelerate control. Lifestyle interventions remain foundational.
The guideline also recommends screening for primary aldosteronism in patients with resistant hypertension, regardless of potassium levels, and elevates urine albumin-to-creatinine ratio testing to standard practice. It promotes multidisciplinary, team-based care to address access barriers and improve outcomes. Home blood pressure monitoring is strongly encouraged, while cuffless devices like smartwatches are discouraged due to accuracy concerns.
Source:
Jones DW, et al. (2025, August 14). Hypertension. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. https://pubmed.ncbi.nlm.nih.gov/40811516/