Perhaps you have heard that the American Heart Association (AHA) and American College of Cardiology (ACC) have released new guidelines regarding hypertension, the condition more commonly know as high blood pressure. Here is what you need to know.
The most notable changes in the updated blood pressure guidelines, the first such update since 2017 — is a shift toward earlier lifestyle intervention for people diagnosed with stage 1 hypertension.
Under the new recommendations, adults with systolic blood pressure (the top number in a blood pressure reading) between 130 and 139 mm Hg will first be directed to adopt healthier habits — unless they are at high risk for cardiovascular disease — before starting medication. Normal blood pressure is considered 120/80 mm Hg or less.
Recommended lifestyle changes include: Engaging in regular physical activity; following a heart-healthy; reducing salt (sodium) intake; and maintaining a consistent daily routine.
If blood pressure does not improve after three to six months of these changes, medication may be considered. This represents a departure from the 2017 guidelines, when drug therapy was often started at a systolic pressure of 140 mm Hg or higher.
Ian Del Conde Pozzi, M.D., cardiologist and vascular medicine specialist at Baptist Health Miami Cardiac & Vascular Institute, who also directs the Resistant Hypertension Clinic, says these changes reflect an increased focus on prevention. Nearly half of U.S. adults have high blood pressure, and about one-third of those hypertensive individuals don’t know they have the condition.
“For many people with stage 1 hypertension, the first step should be lifestyle modification—improving diet, increasing physical activity, reducing salt, and now, avoiding alcohol altogether,” Dr. Del Conde Pozzi explains. “We have stronger data than ever that these measures can lower blood pressure, reduce medication needs, and improve long-term heart and brain health.”
Earlier intervention could significantly reduce the risks of heart attack, stroke, kidney failure, and cognitive decline. “The earlier we act, the more we can prevent complications that often go unnoticed until it’s too late,” Dr. Del Conde added.
The updated guidance also makes a strong statement about alcohol use. While prior guidelines allowed moderate consumption—up to two drinks daily for men and one for women—the AHA and ACC now recommend no alcohol at all for optimal blood pressure control.
For those who do drink, the old limits still apply, but the updated wording underscores that any alcohol may increase cardiovascular risk.
Adopting a Health Lifestyle is Key
The AHA reaffirmed that healthy behaviors—summarized in its Life’s Essential 8 framework—remain the cornerstone of blood pressure control. Specific recommendations include:
- Limiting sodium intake to less than 2,300 mg daily, with a target of 1,500 mg
- Following the DASH diet or similar heart-healthy eating plans
- Engaging in 75–150 minutes per week of physical activity, including both aerobic and resistance training
- Managing stress through mindfulness, meditation, and breathing techniques
- Achieving and maintaining a healthy weight
- Using home blood pressure monitors to track progress
Dr. Del Conde stressed that consistency is key.
“Blood pressure control is not about short-term fixes—it’s about creating lasting habits that become part of daily life,” he explains. “When we lead lifestyles our bodies weren’t designed for — such as being sedentary or having constant access to high-calorie foods — our health can suffer. Regular exercise helps restore our bodies to their natural state, allowing them to function better and helping to prevent many chronic conditions that have become prevalent in modern life.”
