The latest Clinical Practice Guideline from the American College of Cardiology (ACC) and the American Heart Association (AHA), published in JACC, has updated recommendations for clinicians on the prevention, detection, evaluation, and management of high blood pressure in adults. The new guideline reflects the latest research and evidence since February 2015 and replaces the previous version from 2017.
Several key changes include the use of the PREVENT risk calculator to estimate cardiovascular disease risk and guide drug treatment. This calculator combines measures of cardiovascular, kidney, and metabolic health, providing more precise risk estimates for cardiovascular disease.
Recommended screening for primary aldosteronism in patients with resistant hypertension is now mandatory, regardless of whether hypokalemia is present. Clinicians are advised to continue most antihypertensive medications before screening for primary aldosteronism to minimize barriers or delays.
The guideline also introduces new recommendations for pregnant women with chronic hypertension, suggesting treatment with certain medications when systolic and/or diastolic blood pressure levels reach 140/90 mm Hg or higher. Additionally, the guideline updates laboratory testing for initial evaluation, requiring testing of the ratio of urine albumin and creatinine for all patients with high blood pressure.
According to Guideline Writing Committee Chair Daniel W. Jones, MD, “High blood pressure is the most common and most modifiable risk factor for heart disease.” The new 2025 guideline aims to aid clinicians in helping more people manage their blood pressure and reduce the toll of heart disease, kidney disease, Type 2 diabetes, and dementia.
The development of the new guideline involved collaboration with multiple medical societies and the endorsement of several professional organizations. The guidelines will be published in both JACC and Circulation and will inform clinical practice across the lifespan.
Source: https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2025/08/14/15/36/New-ACC-AHA-Guideline-Addresses-Prevention-Detection-Evaluation-and-Management-of-HBP