In 2017, the American Heart Association and the American College of Cardiology updated the guidelines for high blood pressure, or hypertension.
They lowered the threshold from 140/90 to 130/80. This change meant that nearly half of all adults in the U.S.—about 120 million people—were now considered to have high blood pressure.
Sadly, more than 75% of them still don’t have it under control, according to the CDC.
Blood pressure is measured using two numbers. The first number, called systolic pressure, shows how hard your blood pushes against artery walls when your heart beats. The second number, diastolic pressure, shows the same force when your heart rests between beats.
In August 2025, the guidelines were updated again. The definition of high blood pressure didn’t change, but new research was added to help people better manage the condition.
Doctors continue to stress that high blood pressure is dangerous. It raises the risk of heart attacks, strokes, kidney disease, and even dementia. One major study showed that lowering systolic pressure to 120 instead of 140 significantly reduced heart problems and early deaths. That’s why normal blood pressure is now considered 120/80 or below.
People with blood pressure between 121–129 on the top and 80 or lower on the bottom are in the “elevated” category. Once blood pressure reaches 130/80 or more, it’s considered hypertension.
Pregnant women should also be treated for high blood pressure, although their cutoffs are slightly higher. If left untreated, it can lead to serious problems like pre-eclampsia. Some medications are safe during pregnancy and can be used under a doctor’s care.
For many people, making changes in daily life can help lower blood pressure. These include losing weight, exercising, cutting back on salt and alcohol, and practicing stress relief methods like meditation.
Even if someone starts medicine, they still need to work on healthy habits. Doctors usually give people six months to try these lifestyle changes before prescribing drugs.
If blood pressure stays above 140/90 or doesn’t improve with lifestyle changes, doctors will often prescribe medication. There are many types, including water pills, beta-blockers, and medicines that relax blood vessels.
Finding the right one can take time and may involve several doctor visits to adjust the dose. Too-low blood pressure can also cause problems, especially for older adults, such as dizziness or falls.
In some people, blood pressure is very hard to control even with several drugs. About 15% of people have what’s called resistant hypertension. In 2023, a new treatment called renal denervation was approved.
It involves sending a thin tube through the thigh to the kidney arteries to destroy certain nerves that raise blood pressure. It can help some people, although most will still need medication.
There are also new drugs being tested. According to Dr. David Lee, who led trials for renal denervation, there’s renewed interest in better treatments for high blood pressure.
Monitoring blood pressure at home is becoming more common. Doctors recommend using a cuff that goes around the upper arm for the most accurate results. Smartwatches and phones are not yet reliable enough.
Proper technique is important—resting before the measurement, avoiding caffeine or exercise beforehand, and taking multiple readings for accuracy.
Hypertension is known as a “silent” disease because it usually doesn’t cause symptoms. Many people don’t know they have it. Also, many don’t have regular doctors or access to care, which means they don’t get checked often enough.
Even for people who do get treatment, sticking with medication is hard. Many stop taking their pills after a year. That’s why new guidelines encourage team-based care. This means working not only with doctors but also with nurses, pharmacists, dietitians, and community health workers.
This approach could also include home monitoring, telehealth visits, and partnerships with local programs to offer blood pressure checks outside of clinics. Dr. Lee says we need more creative ways to reach people who don’t have easy access to care.
To get an accurate reading at home, follow these tips: Don’t drink caffeine, smoke, or exercise 30 minutes before measuring. Go to the bathroom first. Sit quietly with your back supported and both feet flat on the floor.
Wait five minutes before measuring, take two readings a minute apart, and write down the results. Talk to your doctor about how often to check and how to share the results.
If you care about high blood pressure, please read studies about unhealthy habits that may increase high blood pressure risk, and drinking green tea could help lower blood pressure.
For more information about high blood pressure, please see recent studies about what to eat or to avoid for high blood pressure, and 12 foods that lower blood pressure.
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