In the run-up to World Heart Day on September 29, we published an article by Dr Namita Sharma on August 29. In the same month, the American Heart Association (AHA), in collaboration with several health organizations, released updated guidelines on hypertension, or high blood pressure. These guidelines are comprehensive and primarily intended for medical professionals. However, there are many takeaways for the common people. In this article, Manoj Pandey aims to simplify the guidelines to the extent that they help in our understanding of blood pressure, provide timely updates, and offer practical advice on what to do (and what to avoid) to keep our hearts healthy.
Takeaways from the 2025 high blood pressure guidelines
Manoj Pandey
What is the right blood pressure?
Over the years, there have been many changes in the blood pressure measurements that can be considered normal. The latest well-established norms, until the new guidelines came, was that 120/80 was the normal blood pressure for an adult, and for the elderly, 140/90 was considered normal. There was also a scale that calculated the ‘normal’ BP according to one’s age.
If you do not understand the readings, let me quickly explain that when the heart beats, along with major artilleries - the pipes that carry blood from the heart to different body organs - it has to first pump the blood and then relax a bit before again starting the cycle. So, in one beat, which lasts less than a second, the heart exerts a high pressure on the blood and, when it relaxes, the blood pressure comes down. So, there are two readings: a higher (systolic) and a lower one (diastolic). The unit of measurement of BP is millimeters of mercury (mm/Hg), which compares the arterial pressure against the normal pressure of air in the atmosphere, but conventionally, no one uses the unit.
Let’s come back to the ‘normal’ blood pressure. The new guidelines say that, irrespective of age, the normal blood pressure is less than 120/80. That means, we should strive to keep it to a level below 120/80.
What are the stages of raised blood pressure?
As the diagram shown above shows, blood pressure can go much beyond the normal levels. When the BP goes up to 139/80, it is not yet ‘high’ blood pressure or hypertension, and is referred to as ‘elevated blood pressure.’ In this case, only the upper reading rises. The new guidelines say that this is not a serious condition and needs to be corrected so that it does not lead to high BP.
When the blood pressure is between 120/80 and 139/89 (that is, below 140/90), it is called stage-I hypertension or high blood pressure. Please note that, according to new guidelines, even if one of the readings goes up while the other one is at a lower level, that is supposed to be high blood pressure.
When the BP is more than the high BP levels and either of the readings is above that, but below 180/120, it is called stage-II hypertension.
When either the upper reading of BP crosses 180 or the lower reading crosses 120, it is called severe hypertension. This is a serious condition and needs immediate lowering of BP through medication.
In this condition, if one develops one or more of the following symptoms, it is an emergency. The patient must be given immediate medical treatment. These symptoms are:
Why is blood pressure so important?
The guidelines quote recent research findings to establish that blood pressure is one of the most important health issues worldwide. At the same time, since it is preventable, a timely intervention can lead to substantial improvement in health.
It is estimated that in the adult population, about half the people suffer from raised BP. What makes this prevalence worse is that in most cases, it goes unnoticed because it may not produce any symptoms until it reaches a critical stage.
What are the risks from the high BP and how to manage it?
In addition, it is now known beyond doubt that a rise in the blood pressure (called hypertension, when the rise goes beyond a certain level) leads to many diseases. These include damage to many vital organs such as the brain, heart and kidneys.
It has been reported that high blood pressure increases the risk of cognitive decline and dementia.
The guidelines highlight that 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, a high blood pressure beyond 190/40* can put the lives of the mother and foetus in danger.
The guidelines stress that high BP can afflict people of any age, and, therefore, blood pressure should be monitored from childhood through old age.
Lifestyle changes are quite effective in lowering the BP. As stated before, the new guidelines suggest that effort should be made to lower the elevated blood pressure through changes in diet and other lifestyle changes. Even when the BP is high, a good lifestyle has an important role in managing it.
Regarding the diet, it is recommended that fruits and vegetables should be taken in plenty, salt intake should be reduced, and alcohol consumption should be minimized.
When it comes to lifestyle, physical activities and reducing stress are very important for keeping a check on the blood pressure.
The role of maintaining correct weight has been emphasized. The guidelines say that when overweight, reduction of weight by 5% not only lowers BP but also improves overall health.
High blood pressure is not a stand-alone ailment. There can be an underlying disease or health factor that can aggravate the blood pressure. Therefore, other diseases or disorders should also not be ignored.
The most important take-aways:
If you are interested, you can peruse the guidelines on the official website of American Heart Association (AHA).
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Manoj Pandey is a former civil servant with a keen interest in exploring and analyzing issues related to science, technology and health. He has contributed extensively to this web magazine, particularly in the विज्ञान (Vigyan) and स्वास्थ्य (Swasthaya) categories. While he writes articles in English, he also makes Videos in Hindi showcasing his commitment to informing the common-man on these important issues. His videos can be seen on YouTube under the heading 'Hindi Health Videos' .
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