The American Heart Association and the American College of Cardiology have released a new clinical guideline focusing on the prevention and early treatment of high blood pressure to reduce the risk of cardiovascular disease, including heart attack, stroke, and heart failure, as well as kidney disease, cognitive decline, and dementia. Nearly half of all adults in the U.S. have high blood pressure, making it the number one preventable risk factor for these conditions.
The guideline introduces the use of the American Heart Association’s PREVENT™ risk calculator, available at https://professional.heart.org/en/guidelines-and-statements/prevent-calculator, to estimate a person’s cardiovascular disease risk, allowing for more personalized treatment plans. It also recommends early intervention with lifestyle modifications and, if necessary, medications to manage blood pressure effectively. The importance of monitoring and treating high blood pressure before, during, and after pregnancy is highlighted to reduce the risk of complications such as preeclampsia.
Healthy lifestyle behaviors are underscored as critical in preventing and managing high blood pressure. Recommendations include limiting sodium intake, maintaining a healthy weight, following a heart-healthy diet like the DASH eating plan, increasing physical activity, and managing stress. The guideline also advises home blood pressure monitoring to help individuals track their progress and tailor their care. Information on the DASH eating plan can be found at https://www.nhlbi.nih.gov/education/dash-eating-plan.
For those requiring medication, the guideline suggests starting treatment with two medications at once for stage 2 hypertension and considers newer therapies like GLP-1 medications for patients with high blood pressure and overweight or obesity. The association between high blood pressure and cognitive decline is also addressed, with early treatment recommended to maintain brain health. This comprehensive approach to high blood pressure management, developed in collaboration with 11 other health care organizations, aims to provide clinicians with the tools needed to help patients achieve and maintain optimal blood pressure levels, thereby reducing the risk of serious health complications. The full guideline is published in the journal Circulation, accessible at https://www.ahajournals.org/doi/10.1161/CIR.0000000000001191.
