A new set of guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) recommend initiating medication therapy sooner in adults with high blood pressure. The target blood pressure level remains below 130/80 mm Hg, but the guidelines suggest starting treatment earlier if blood pressure remains at or above this threshold after three to six months of lifestyle changes.
According to Dr. Daniel W. Jones, chair of the guidelines committee, the goal is to start preventing cardiovascular disease earlier. The new guidelines also recommend antihypertensive medications for adults with diabetes, chronic kidney disease, or an elevated risk of cardiovascular disease.
The guidelines focus on reducing salt intake, staying physically active, lowering weight, and managing stress to blunt the risk of dementia, heart attack, stroke, heart failure, and kidney disease. They also call for screening primary aldosteronism in patients with resistant hypertension.
Key changes include capping sodium intake at 1500mg per day, limiting alcohol consumption, and recommending a daily limit of one or two alcoholic beverages depending on sex. The guidelines also emphasize the importance of losing weight to lower blood pressure and suggest using GLP-1 inhibitors when clinically appropriate.
Additionally, women who are pregnant or expecting to become pregnant should consider low-dose aspirin to prevent preeclampsia. The new guidelines provide more time for discussing pregnancy-related hypertension, recognizing that high blood pressure during pregnancy can lead to lifelong hypertension.
Source: https://www.medscape.com/viewarticle/bp-meds-should-begin-promptly-new-acc-aha-guidelines-say-2025a1000lms