A new guideline has been released by leading medical groups, setting the ideal blood pressure goal for all US adults at below 120/80 mm Hg. The American Heart Association and the American College of Cardiology recommend lowering blood pressure to this level to reduce the risk of dementia, cognitive impairment, and cardiovascular disease.
The guideline is based on a cluster-randomized controlled trial in rural China that showed significant benefits from intensive blood pressure control. Well-controlled blood pressure below 130/80 mm Hg lowered the risk of dementia by 15% and cognitive impairment by 16%. The new goal of 120/80 mm Hg was endorsed in 2017 but underwent scrutiny for its 2025 guideline, which is now being supported.
The recommendations encourage earlier treatment of high blood pressure, emphasizing the importance of lifestyle changes such as a better diet, regular physical activity, and periodic monitoring. Doctors are advised to prescribe prevention in people with elevated numbers and combine two blood pressure drugs if necessary. Low-dose aspirin is also suggested during pregnancy to reduce the risk of pre-eclampsia and eclampsia.
The guideline also highlights the importance of weight loss, potassium-enriched salt substitutes, and limiting sodium intake to 1,500 mg per day. Doctors may consider obesity drugs like GLP-1s in certain cases. The goal is not to drastically change patient behavior but rather to encourage doctors to improve their efforts.
While evidence from China might be limited due to differences in diet, the new guidelines aim to provide clearer guidance for healthcare professionals and patients worldwide.
Source: https://www.statnews.com/2025/08/14/high-blood-pressure-new-guidelines-add-dementia-risk