Research Highlights:
Embargoed until 4 a.m. CT/5 a.m. ET Weds., July 29, 2026
DALLAS, July 29, 2026 — Nearly 23 million Americans with blood pressure 130/80 mm Hg or higher may be eligible for blood-pressure-lowering medications based on the 2025 American Heart Association/American College of Cardiology guideline , according to new, independent research published today in the Journal of the American Heart Association , an open access, peer-reviewed scientific journal of the American Heart Association.
The 2025 American Heart Association/American College of Cardiology High Blood Pressure guideline advises lifestyle changes — eating a healthy diet, managing weight, getting regular physical activity and reducing salt and alcohol — as a key part of treatment for high blood pressure, with medication prescribed if appropriate. The guideline also suggests healthcare professionals use the American Heart Association’s PREVENT TM (Predicting Risk of cardiovascular disease EVENTs) risk equations to calculate 10-year cardiovascular disease risk among adults (ages 30-79 without known cardiovascular disease) with high blood pressure who do not have established cardiovascular disease.
This study is one of the first detailed assessments of the 2025 guideline on high blood pressure and updated cardiovascular disease risk estimates using the PREVENT risk equations.
“Through this study, our goal was to understand how many people may qualify for treatment according to the updated recommendations in the guideline and estimate how many deaths from any cause and from cardiovascular disease may be prevented in the long term if the guideline recommendations were applied and untreated patients received care that included medication,” said study lead author Mustafa Al-Jarshawi, M.B.Ch.B., M.Sc., MRCPUK, PgCert, an academic clinical fellow in cardiology, member of the Cardiovascular Research Group at the Centre for Prognosis Research at Keele University in the United Kingdom and honorary research fellow at the Centre for Health Informatics, University of Manchester.
Researchers examined links between blood pressure treatments and rates of deaths from all causes and from cardiovascular conditions. Their analysis predicted how many lives may be saved if treatment plans outlined in the 2025 guideline were prescribed.
The data analysis found:
“What stood out most was the size of the treatment gap — more than 40% of people who were clearly eligible under the new guideline were not receiving treatment, as well as the scale of the potential benefit,” Al-Jarshawi said.
“Lifestyle modification remains the foundation of high blood pressure management. Maintaining a healthy weight, consuming a heart-healthy diet, reducing sodium intake, increasing physical activity, getting enough sleep, managing stress and limiting alcohol can meaningfully lower blood pressure and overall cardiovascular risk,” said study senior author Mamas A. Mamas, M.D, DPhil., Professor of Cardiology at Keele University and Honorary Professor of Population Health at the University of Manchester. “For many people, especially those with blood pressure under 140/90 mm Hg and no history of heart disease, stroke, chronic kidney disease or diabetes, lifestyle changes can be enough at first. If your 10-year risk of heart disease is low, with a PREVENT score under 7.5%, maintaining a healthy lifestyle can help you delay or avoid needing medication. Even if you do need medication to lower blood pressure, making lifestyle changes is important for effective treatment and overall health.”
“The 2025 guideline emphasizes a personalized approach to managing high blood pressure by considering blood pressure levels plus 10-year and 30-year overall cardiovascular disease risk. The American Heart Association’s PREVENT risk equations help to identify individuals who could benefit from treatment before a major cardiac event,” said Chair of the American Heart Association’s 2025 guideline writing committee Daniel W. Jones, M.D., FAHA.
“Controlling blood pressure is crucial for long-term health. While lifestyle changes are the foundation for better overall health, people with high blood pressure and higher risk for cardiovascular disease may also need medication to reduce the risk of serious complications from untreated high blood pressure. Healthcare professionals should assess overall cardiovascular risk and work together with their patients to combine lifestyle strategies and medication for optimal blood pressure control.” Jones, who was not involved in this study, is a past volunteer president of the American Heart Association (2007-2008) and is dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi.
Study details, background, design and limitations:
Co-authors, disclosures and funding sources are listed in the manuscript.
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Journal of the American Heart Association
Population-Level 10-Year Implications of the New 2025 American Heart Association/American College of Cardiology Hypertension Guideline Recommendations for Primary Prevention in the United States: A NHANES-Based Cohort Study (2009–2018)