Approximately half of American adults suffer from high blood pressure, the leading preventable risk factor for heart disease, stroke, heart attack, heart failure, kidney disease, and even dementia.
For the first time since 2017, the American Heart Association (AHA) and American College of Cardiology have refreshed their guidelines to assist individuals with high blood pressure in lowering their numbers.
“The new guidelines represent an accumulation of recent evidence that provides better opportunities for longer and healthier lives,” stated Daniel W. Jones, MD, dean emeritus at the University of Mississippi Medical Center School of Medicine and chair of the guideline writing committee.
The classifications of normal, elevated, and high blood pressure—measured with a blood pressure cuff—remain unchanged:
- Normal blood pressure: Below 120/80 mm Hg
- Elevated blood pressure: Between 120-129/80 mm Hg
- High blood pressure: At or above 130/80 mm Hg
Key takeaways from the new guidelines for individuals with high blood pressure:
The updated recommendations suggest that doctors should prescribe medications to patients with high blood pressure more promptly, especially if lifestyle changes over three to six months aren’t effective in lowering their numbers.
A crucial motivation behind this approach, mentioned by Jones, is the discovery that high blood pressure contributes to cognitive decline as well.
Even if medication becomes necessary, doctors will still encourage healthy habits such as regular exercise and a balanced diet, noted Scott Jerome, MD, director of Ambulatory Services at the University of Maryland School of Medicine.
The update continues to urge limiting sodium intake to less than 2,300 mg per day (approximately one teaspoon of salt), with an ideal goal of no more than 1,500 mg per day.
The AHA advises examining food labels, as most sodium in the American diet comes from packaged and restaurant foods. Many restaurants list sodium content online or can adjust preparations upon request.
At home, consider using salt substitutes with potassium and increasing consumption of potassium-rich foods like bananas, spinach, mushrooms, and honeydew melon.
The guidelines discourage alcohol consumption; recommending no more than two drinks per day for men and one drink per day for women.
A 2023 review in Hypertension suggests that every additional alcoholic beverage may increase blood pressure over time, even for those without high blood pressure.
The guidelines emphasize stress management through exercise and techniques such as yoga, deep breathing, and meditation, as stress is linked to heart disease.
The recommendation remains the same: 75-150 minutes of weekly exercise, including aerobic activities like brisk walking and strength training with bands or weights.
The new guidelines recommend losing at least 5% of body weight for those who are overweight or obese. Discuss dietary changes, weight-loss medications like Wegovy or Zepbound, or weight loss surgery with your doctor.
Healthy eating remains a cornerstone, with particular emphasis on the DASH diet, which focuses on reducing salt and increasing produce, whole grains, legumes, nuts, seeds, low- or no-fat dairy, poultry, and fish.
A key point stressed by Allen Taylor, MD, chairman of Cardiology at MedStar Heart & Vascular Institute in Washington DC, is the importance of knowing your blood pressure numbers. Having a home cuff, sharing readings with your doctor, and discussing any changes are essential for optimal management.