KUWAIT CITY, Sept 25: Nearly half of all adults in the United States have high blood pressure, a condition known as hypertension. It is the leading risk factor for heart disease and stroke, and also raises the risk of dementia and cognitive decline. Heart disease, stroke, and dementia rank among the top causes of death in the country. However, only about one in four people with high blood pressure currently have it under control.

In August 2025, the American Heart Association and the American College of Cardiology released updated guidelines for the prevention and management of hypertension. These new guidelines reflect a thorough review of research from the past decade.

One major change in the guidelines is a stricter definition of hypertension with lower blood pressure targets. Blood pressure is measured using two numbers: systolic pressure (the top number, indicating pressure when the heart pumps) and diastolic pressure (the bottom number, indicating pressure when the heart rests). Both numbers are important in diagnosing and treating high blood pressure.

The category previously called “prehypertension” (systolic 120-139 mm Hg or diastolic 80-99 mm Hg) has been removed. Now, blood pressure levels are classified as follows:

These lower thresholds mean that many more people will be diagnosed with hypertension, potentially impacting millions nationwide. Individuals need to consult their doctors to understand their status under these new criteria and to receive guidance on treatment.

Lifestyle changes remain a key component of managing blood pressure. Doctors are encouraged to use a risk assessment tool called PREVENT (Predicting Risk of Cardiovascular Disease EVENTS) to evaluate a patient’s overall cardiovascular risk and tailor treatment accordingly.

The guidelines highlight that alcohol consumption can raise blood pressure. A study from 2023 showed that systolic blood pressure increases by about 1 mm Hg for every 10 grams of alcohol consumed—equivalent to slightly less than one standard beer. Regular drinking can therefore raise blood pressure over time, but reducing excessive alcohol intake can help lower it.

Because alcohol adds to other risk factors—such as inactivity, obesity, poor sleep, stress, and smoking—cutting back is an important way to protect heart health. The updated guidelines advise limiting alcohol to no more than two drinks per day for men and one drink per day for women, encouraging reduction or elimination of alcohol where possible.

Dietary changes are also emphasized. Adults are advised to consume less than 2,300 milligrams of sodium (about one teaspoon of salt) daily, ideally aiming for less than 1,500 milligrams. The average American currently consumes over 3,300 milligrams daily. Using potassium-based salt substitutes may further help reduce blood pressure.

The guidelines recommend the DASH diet (Dietary Approaches to Stop Hypertension), which focuses on fruits, vegetables, whole grains, and low-fat or nonfat dairy. Following this diet can lower blood pressure by up to 10 mm Hg.

Physical activity is another important factor. On average, adding 30 minutes of aerobic exercise each week can reduce systolic blood pressure by 2 mm Hg and diastolic pressure by 1 mm Hg, with the greatest benefits seen at 150 minutes of exercise weekly.

These updated guidelines underscore the importance of both lifestyle changes and medical management in reducing the risks associated with high blood pressure, including heart disease, stroke, and dementia.