In August 2025, the American Heart Association (AHA) issued fresh guidelines on hypertension or high blood pressure, modifying its existing guidelines of 2017.
The detailed document has guidelines mostly for doctors and other care givers. However, there are some tips for the common people, which I am sharing here.
In short, these guidelines update the earlier concepts about blood pressure and how to deal with it.
What is normal blood pressure- 120/80?
It is generally held that 120/80 is the normal blood pressure for an adult, and 140/90 for the elderly.
The new guidelines say that only a blood pressure below 120/80 can be considered normal, and that applies irrespective of age.
A blood pressure level up to 139/80 is called ‘elevated blood pressure.’ The guidelenes say blood pressure up to this level should be brought to normal through lifestyle interventions, avoiding medicines.
Blood pressure levels between 120/80 and 139/89 (that is, below 140/90), is called stage-I hypertension or high blood pressure.
A level more than the high BP levels and either of the readings shooting above that, but below 180/120, is called stage-II hypertension.
A level above that, in which either of the readings shoots above the given level (180 or 120), is severe hypertension. This is considered serious, needing immediate lowering of blood pressure through medication.
When severe hypertension is accompanied by one or more of the following symptoms, it is an emergency. The patient must be given immediate medical treatment. These symptoms are:
- Chest pain
- Shortness of breath
- Back pain
- Numbness
- Weakness
- Change in vision
- Difficulty speaking
Why is blood pressure important?
Recent research has established that blood pressure is one of the most important health issues globally. The silver lining is that it is preventable and a timely intervention can lead to substantial improvement in health. Therefore, the guidelines emphasize that high blood pressure should be monitored regularly, irrespective of age.
It is estimated that in the adult population, about half the people suffer from raised blood pressure. In most cases, it goes unnoticed because it may not produce any symptoms until it reaches a critical stage.
What are the risks from high blood pressure?
A rise in the blood pressure can give rise to many diseases, including those of many vital organs such as the brain, heart and kidneys.
High blood pressure increases the risk of cognitive decline and dementia.
High blood pressure is the leading risk factor for stroke and a number of heart conditions such as coronary artery disease and heart failure.
Though the blood pressure commonly increases during pregnancy, it should be managed below 190/40 so that it does not put the lives of the mother and foetus at risk.
How to manage high blood pressure?
The guidelines lay empahsis on lifestyle changes as the first line of action to manage the blood pressure within acceptable limits. These include diet, exercise, ways to reduce stress, quitting smoking, reducing the intake of alcohol and so on.
Fruits and vegetables should be taken in plenty and salt intake should be reduced to below 2300 mg per day.
When overweight, aim should be to reduce the weight by 5%, which is found effective not only in reducing the blood pressure but also improving overall health.
The guidelines also bring to attention the fact that high blood pressure is not a stand-alone disease or symptom but can be associated with other health issues, including those of kidneys and endocrine glands.
