Overview

• The 2025 guidance is the first major update since 2017 and keeps diagnostic thresholds unchanged while shifting more strongly toward prevention and early action.
• For systolic readings of 130–139 mm Hg, clinicians are advised to start with lifestyle changes and add medication if targets are not met after three to six months.
• Adults with elevated blood pressure are urged to avoid alcohol; for those who choose to drink, the limits remain one daily drink for women and two for men.
• Lifestyle measures are emphasized, including sodium below 2,300 mg per day with an ideal target of 1,500 mg, regular exercise, weight management, home blood pressure monitoring, and selective use of GLP-1 medications.
• The guideline promotes the PREVENT risk calculator to tailor care and calls for closer blood pressure management before, during and after pregnancy, with treatment during pregnancy when readings reach 140/90 mm Hg.