Overview

• Adults with hypertension should now aim for a systolic reading of 130 mm Hg or lower, with an ideal target of 120 mm Hg.
• For people at lower 10‑year cardiovascular risk by the PREVENT calculator, medication is recommended if blood pressure stays at or above 130/80 mm Hg after 3–6 months of lifestyle changes.
• Readings at or above 140/90 mm Hg call for starting two blood pressure drugs immediately to improve control.
• The guidance doubles down on lifestyle steps, urging sodium intake toward 1,500 mg per day, limiting alcohol to no more than one drink daily for women and two for men, and promoting weight loss and regular activity.
• Targeted testing expands for higher‑risk patients with stage 2 hypertension, including urine albumin‑to‑creatinine and aldosterone‑to‑renin ratios, and evidence now more clearly links intensive control to reduced cognitive decline in addition to cardiovascular and kidney protection.