NEW YORK, Sept 8: High blood pressure, often called the silent killer, affects more than half of Americans by age 40 and remains one of the leading causes of heart disease, stroke, kidney damage, and dementia. Despite its dangers, many people are unaware they have it because hypertension typically has no symptoms.

New recommendations from the American Heart Association stress the importance of early intervention, urging lifestyle changes and, if necessary, medication once systolic blood pressure rises above 130/80 mm Hg. Experts say acting early can significantly extend healthy life expectancy by reducing the risks of stroke, heart attack, and cognitive decline.

“There's a really enormous preventive health opportunity in treating hypertension earlier,” says Dr. Jordana Cohen, a nephrologist and hypertension specialist at the University of Pennsylvania. Millions of adults in the U.S., she adds, could benefit from timely medication and lifestyle changes.

For those with systolic blood pressure in the 130s, the guidelines recommend dietary adjustments, exercise, stress management, and limited alcohol intake. If levels remain high, medication should be introduced. Once readings hit 140/90 mm Hg or higher — stage 2 hypertension — the recommendation is to start with two medications, since one alone is often insufficient.

Despite awareness, more than half of patients fail to lower their blood pressure to the normal range of 120/80 mm Hg. Side effects, reluctance to take medication, and difficulty maintaining lifestyle changes are among the challenges. Healthcare providers also use risk calculators to tailor treatment to individual heart disease risk.

George Solomon, a retired law enforcement officer, initially ignored medical advice because he “felt fine.” At age 63, he suffered a stroke. After treatment and rehabilitation, he has regained about 80% of his abilities and now maintains a strict routine of exercise, weight management, and medication. He hopes his story will encourage others to take hypertension seriously.

Current treatments include diuretics, ACE inhibitors, and calcium channel blockers, all designed to lower blood pressure in different ways. However, many patients still struggle to reach safe levels.

Promising research has emerged around a new class of drugs that target aldosterone, a hormone that regulates sodium and fluid. A study published in the New England Journal of Medicine found that the experimental drug baxdrostat reduced blood pressure by about 10 points in patients who had not responded to other treatments. Sponsored by AstraZeneca, the study involved around 800 participants and showed that a 10-point drop can reduce the risk of heart attacks and strokes by roughly 20%.

High blood pressure may be silent, but its consequences are severe. The latest guidelines highlight that lifestyle changes, early detection, and timely medical treatment can help millions live longer, healthier lives—and avoid devastating outcomes like stroke and dementia.