The American Heart Association (AHA) has recently revised its guidelines on hypertension, the leading risk factor for stroke and various heart diseases, like coronary artery disease, heart failure and atrial fibrillation (AFib), reports Medical News Today.
According to the WHO, one in three adults, or 1.3bn people worldwide, have hypertension, so preventing, detecting and treating it could prevent 76m deaths between now and 2050.
The full guidelines, published in the journal Hypertension, aim to help medical practitioners detect and treat hypertension, but also contain valuable advice to help people control and manage their own blood pressure.
Cheng-Han Chen, MD, board certified interventional cardiologist and medical director of the Structural Heart Programme at MemorialCare Saddleback Medical Centre in California, who was not involved in developing the guidelines, said the updated information emphasises earlier assessment and intervention of elevated blood pressure.
“In particular, it affirms the importance of lifestyle changes to help control blood pressure, such as with limiting sodium and alcohol intake, eating a heart healthy diet, maintaining physical activity, and managing weight and stress. This is a welcome message that will hopefully help us manage hypertension before it contributes to more serious cardiovascular disease.”
Review of studies
To update their guidelines, the AHA carried out a comprehensive review of clinical studies, reviews and other evidence about hypertension published since February 2015.
They describe the guidelines as a “living, working document updating current knowledge in the field of high blood pressure aimed at all practicing primary care and speciality clinicians who manage patients with hypertension”.
Daniel Jones, MD, FAHA, volunteer chair of the guideline writing committee and a past-president of the AHA (2007-2008), Dean and Professor Emeritus of the University of Mississippi School of Medicine, and a member of the writing committee for the 2017 high blood pressure guideline, said: “All adults should have their blood pressure measured at least once a year, more often for patients with any level of high blood pressure. Patients with high blood pressure who have a reading above 180/120 mmHg should seek advice from their clinician, urgently, if there are symptoms of chest pain, shortness of breath, paralysis or speech difficulty.”
Key points
Jones highlighted some key updates for 2025, which include:
- the goal of achieving a systolic blood pressure of 130 mmHg or below, and ideally of 120 mmHg, for adults with high blood pressure; and
- more clear and robust evidence that intensive lowering of blood pressure reduces the risk of cognitive decline and dementia.
“In adults with an average blood pressure of 130/80 mm Hg (or more), and at lower 10-year cardiovascular disease risk defined by the PREVENT risk calculator of <7.5%, initiation of medication therapy to lower blood pressure in addition to lifestyle modification are recommended if average BP remains 130/80 mmHg [or more] after an initial three- to six-month trial of lifestyle modification only.”
The guidelines also recommend “moving toward an ideal limit of 1500 mg/day (milligrams per day)” for sodium consumption.
“These new guidelines will hopefully encourage clinicians to further recommend lifestyle changes to patients with elevated blood pressure. They also promote the use of a specific risk calculator to help us determine which patients may benefit most from medical therapy for hypertension,” Chen told MNT.
Overweight or obese patients are also advised to shed at least 5% of their body weight to help lower or prevent hypertension.
“Nearly one of every two adults in the US has high blood pressure, and it is the number one modifiable risk factor for CVD. Every person has the opportunity to change the course of their future, their health — annual screening, prevention and early treatment for high blood pressure are the keys to a longer, healthier life,” said Jones.
MedicalNewsToday article – Revised AHA guidelines on hypertension: What's new?
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New NICE hypertension guidelines a ‘pragmatic compromise’ — The Lancet
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