High blood pressure is one of the leading causes of heart attacks, strokes, kidney disease and early death around the world.
Many people do not realise they have it because it often causes no symptoms until serious damage has already occurred.
A new study published in the Journal of the American Heart Association suggests that millions more Americans may benefit from blood-pressure-lowering medicines under the 2025 American Heart Association and American College of Cardiology guideline.
High blood pressure is generally measured in millimetres of mercury, written as mm Hg. A reading contains two numbers. The first is systolic blood pressure, which measures pressure when the heart beats.
The second is diastolic blood pressure, which measures pressure between beats. The new guideline recommends considering treatment for many adults with blood pressure of 130/80 mm Hg or higher after also assessing their overall cardiovascular risk.
Researchers wanted to estimate how many people might qualify for treatment and how many lives could potentially be saved if the guideline were fully applied. They analysed information from the National Health and Nutrition Examination Survey together with long-term outcome data.
The study found that about 81 million U.S. adults had high blood pressure. Among them, 22.8 million met the guideline criteria for blood-pressure-lowering medication. However, almost 9.7 million eligible adults were not receiving treatment.
The researchers estimated that people who received blood pressure medicines had a 23% lower risk of dying from any cause and a 50% lower risk of dying from cardiovascular disease than similar eligible people who remained untreated.
If all untreated but eligible adults received medication, about 200,000 deaths from all causes and 162,000 cardiovascular deaths might be prevented over the next decade.
The updated guideline does not rely on blood pressure alone. Doctors are encouraged to use the American Heart Association’s PREVENT risk calculator to estimate a person’s chance of developing cardiovascular disease over the next 10 years. This helps tailor treatment to each individual.
Lifestyle changes remain the first step for everyone. Healthy eating, reducing salt, maintaining a healthy weight, exercising regularly, limiting alcohol, sleeping well and managing stress all help lower blood pressure. For people at lower overall risk, these changes may be enough to delay or avoid medication.
The study also found that people most likely to benefit from medication tended to be older and were more likely to have diabetes, chronic kidney disease or other cardiovascular risk factors.
The authors note important limitations. Blood pressure readings in the analysis were based on a single clinic visit, while the guideline recommends confirming high blood pressure using repeated measurements on different occasions. Because the study was observational, it estimated likely benefits rather than directly proving that following the guideline would prevent these deaths.
This research suggests that applying the new blood pressure guideline more consistently could prevent many deaths by identifying eligible people who are currently untreated. At the same time, it reinforces that medicines work best when combined with long-term lifestyle improvements and personalised assessment of cardiovascular risk.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
Source: Keele University.
