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2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: a commentary from the European Rena

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  • #cardiovascular risk
  • #hypertension
  • #BP guidelines
  • 2025 AHA/ACC and other American Scientific Societies updated the Guideline on High Blood Pressure.
  • Guidelines generally agree on pharmacotherapy eligibility and common BP targets (SBP <130 mmHg, DBP <80 mmHg) for most patients.
  • 2025 AHA/ACC supports earlier pharmacotherapy and lower BP targets compared to other guidelines.
  • AHA/ACC recommends or finds it reasonable to initiate pharmacotherapy for hypertension (SBP ≥130 mmHg or DBP ≥80 mmHg).
  • Target BP for high CVD risk is SBP <130 mmHg, with encouragement for SBP <120 mmHg, and DBP <80 mmHg.
  • 2024 ESC and 2023 ESH use different terms (high normal or elevated BP) for BP values requiring pharmacotherapy only in high-risk groups.
  • 2023 ESH advises against actively aiming for SBP <120 mmHg or DBP <70 mmHg.
  • 2024 KDIGO suggests a target SBP <120 mmHg for CKD patients and avoids the term 'hypertension'.
  • There is a need for convergence among guidelines on nomenclature and therapeutic targets.