AHA Blood Pressure Guidelines 2025: What the New Guideline Says

The AHA blood pressure guidelines were updated in August 2025, when the American Heart Association and the American College of Cardiology published a new guideline for high blood pressure in adults. For most people, the biggest news is that the numbers didn't move. Normal is still under 120/80, and high blood pressure (hypertension) still starts at 130/80.

What's new is how doctors estimate your risk, how long lifestyle changes get before medication comes up, and how much weight the guideline puts on readings you take at home. Here's what the new blood pressure guidelines say, in plain words.

What are the new AHA guidelines for blood pressure?

They're the 2025 AHA/ACC guideline, published on August 14, 2025 in Circulation, Hypertension, and JACC, and it replaces the 2017 guideline. Its overall treatment goal is a blood pressure under 130/80 for all adults, with some extra considerations for people who are pregnant, live in institutional care, or have a limited life expectancy.

The AHA's news release frames the whole thing around prevention: healthy habits first, plus earlier medication when it's needed, to lower the risk of heart attack, stroke, heart failure, kidney disease, and dementia. Nearly half of US adults (46.7%) have high blood pressure.

What is the new blood pressure range under the 2025 guideline?

The four main categories are the same as in 2017: normal, elevated, stage 1 hypertension, and stage 2 hypertension. The AHA's patient chart adds two rows above them for very high readings, called severe hypertension and hypertensive emergency.

The first four rows come from Table 4 of the guideline. The last two come from the AHA's blood pressure categories chart.

Two footnotes in the guideline change how you read it:

• Your category comes from an average. The table is based on an average of at least 2 careful readings taken on at least 2 separate occasions. One reading doesn't put you in a category.
• The higher number wins. If your top and bottom numbers land in different categories, you go in the higher one. So 126/84 is stage 1, because 84 is in the stage 1 range on its own.

For a row-by-row walk through the chart, see our blood pressure chart guide. If you sit in the 120s, our guide to elevated blood pressure (120 to 129) covers that range in detail.

What changed from the 2017 guideline?

The categories and the 130/80 threshold stayed the same, so a chart you learned in 2017 still holds. The changes are in how risk is estimated, when medication comes up, one name, and a few specific groups.

The main ones, from the guideline, the AHA release, and a 2025 review in Hypertension:

• A new risk calculator. Doctors now use the AHA's PREVENT equations to estimate your 10-year risk of heart attack, stroke, and heart failure. PREVENT covers adults 30 to 79, includes kidney function and statin use, and was built from data on 3.2 million people. The line for "higher risk" dropped from 10% on the old calculator to 7.5% on PREVENT.
• A time limit on lifestyle-only treatment. For lower-risk adults at 130/80 or above, medication is now recommended if 3 to 6 months of lifestyle change hasn't brought the average below 130/80. The ACC's summary lists this as new.
• A brain health goal. The guideline recommends a systolic (top number) under 130 to help prevent cognitive impairment and dementia. The ACC notes it's a Class 1, Level A recommendation, the guideline's top rating.
• A new name. "Hypertensive urgency" is now "severe hypertension."
• A kidney test for everyone. A urine albumin-to-creatinine ratio is now recommended for all patients with high blood pressure. In 2017 it was optional.
• Pregnancy. For pregnant women with chronic high blood pressure, treatment is recommended at 140/90 or higher, with continued monitoring after delivery.

What does the guideline say about measuring at home?

It recommends home blood pressure monitoring to help confirm a diagnosis made in the office, and to track how treatment is going. It also says home readings work best as part of a plan with your care team, using a standard way of measuring.

The AHA's home monitoring page spells out the method:

1. Use a validated, automatic, upper-arm cuff that fits your arm. Wrist and finger monitors aren't recommended.
2. Skip smoking, caffeine, and exercise for 30 minutes beforehand, and empty your bladder.
3. Sit still with your arm supported on a flat surface at heart level. Put the cuff on bare skin, just above the bend of your elbow.
4. Rest quietly for at least 5 minutes. No talking, no phone.
5. Each time you measure, take two readings one minute apart, and write both down.
6. Measure at the same time each day.

In the guideline's Table 7, a home average of 130/80 matches 130/80 in the office, while a home average of 135/85 matches 140/90 in the office. The guideline says to read these home thresholds with some caution, since most of the data came from outside the US.

If you use a blood pressure app for this (ours included), the guideline has a fair point for you. It cites trials where a smartphone app that only reminded people to measure and stored their readings didn't lower blood pressure more than home monitoring alone. The bigger gains came when home readings were paired with patient education, telehealth, and medication adjustments by a care team.

Our step-by-step guide on how to measure blood pressure at home covers cuff size, posture, and the small mistakes that add points.

When does the guideline recommend starting medication?

Doctors weigh two things: your average blood pressure and your overall risk of heart disease and stroke. The higher either one is, the earlier the guideline recommends adding medication to lifestyle changes.

This is how the AHA's summary of the guideline lays it out:

• Average of 140/90 or higher (stage 2): medication plus lifestyle changes is recommended for all adults.
• Average of 130/80 or higher, with higher risk: medication plus lifestyle changes is recommended for adults who have heart or blood vessel disease, a previous stroke, diabetes, chronic kidney disease, or a PREVENT 10-year risk of 7.5% or more.
• Average of 130/80 or higher, with lower risk: a 3- to 6-month trial of lifestyle change comes first. If the average is still 130/80 or higher after that, medication is recommended.
• Elevated (120 to 129): lifestyle changes. The guideline's medication recommendations start at 130/80.

Your doctor starts from these rules and fits them to you. Please don't start, stop, or change a blood pressure medicine based on a guideline or a week of home readings. Bring the readings in and decide together.

What lifestyle changes does the guideline recommend?

The guideline strongly recommends lifestyle changes for every adult, whatever their numbers. The AHA calls healthy habits the first line of care.

The specifics, from the AHA release:

• Sodium: under 2,300 mg a day, moving toward an ideal of 1,500 mg. Most of it comes from packaged and restaurant food, so the AHA suggests checking food labels.
• Potassium: eat more of it in your food.
• Eating pattern: a heart-healthy plan such as DASH, heavy on vegetables, fruits, whole grains, legumes, nuts, seeds, and low-fat dairy.
• Weight: for adults with overweight or obesity, a goal of losing at least 5% of body weight.
• Activity: at least 75 to 150 minutes a week of aerobic exercise, resistance training, or both.
• Alcohol: ideally none. If you drink, no more than 2 drinks a day for men and 1 for women.
• Stress: exercise, plus techniques like meditation, breathing exercises, or yoga.

Small changes, repeated, add up here. Pick the two you'll actually keep doing and start there.

When to call a doctor, and when to call 911

Call 911 if your blood pressure is higher than 180/120 and you have symptoms such as chest pain, shortness of breath, back pain, numbness, weakness, a change in vision, or difficulty speaking. The AHA calls this a hypertensive emergency and says not to wait to see whether it comes down on its own.

If you read higher than 180/120 and feel fine, wait at least a minute and measure again. If it's still that high, the AHA says to contact your healthcare professional right away. The guideline calls this severe hypertension and says it should be evaluated and treated promptly, usually without a hospital stay.

Call your doctor soon (not urgently) if your home averages sit at 130/80 or above over a week or more, or if you're on treatment and your averages stay above the goal you agreed on. Our guide to sharing home readings with your doctor covers what's most useful to bring.

Common questions

Did the 2025 guideline change what counts as high blood pressure?

No. High blood pressure still starts at an average of 130 top or 80 bottom, the same threshold set in 2017.

What is the PREVENT calculator?

It's an AHA risk calculator for adults aged 30 to 79 that estimates 10-year and 30-year risk of heart attack, stroke, and heart failure. It uses age, sex, blood pressure, cholesterol, kidney function, and even your zip code.

Can I use my smartwatch to check my blood pressure?

The guideline says not to rely on cuffless devices, smartwatches included, for accurate blood pressure readings until they show better precision and reliability. A validated upper-arm cuff is the standard.

Does the guideline apply during pregnancy?

The category table excludes pregnant people, and the guideline has a separate section for blood pressure before, during, and after pregnancy. If you're pregnant or planning to be, talk with your obstetric team about your numbers.

How BP Log helps

BP Log follows the home method the AHA describes. It guides you through two readings, one minute apart, times the gap for you, and averages them automatically. Each reading is placed in the 2025 guideline categories, and you can see your morning and evening averages separately. Since the guideline found home readings help most when a care team uses them, the doctor visit report puts a summary and every reading in one place for your appointment. If you prefer paper, our printable blood pressure log works too.