23 Million Americans May Need New BP Meds Under Updated Guideline

Nearly 23 million Americans with high blood pressure may now be eligible for medication under the updated 2025 American Heart Association/American College of Cardiology guideline, according to new research published in the Journal of the American Heart Association. The study, led by Mustafa Al-Jarshawi from Keele University, analyzed data from 81 million U.S. adults with hypertension and no prior cardiovascular disease. It found that 28% (22.8 million) qualify for blood pressure-lowering drugs based on readings of 130/80 mm Hg or higher. Alarmingly, 9.7 million of these eligible individuals remain untreated, representing a significant treatment gap. The 2025 guideline emphasizes a personalized approach using the American Heart Association’s PREVENTTM risk equations to calculate 10-year cardiovascular disease risk, helping clinicians decide when to initiate medication alongside lifestyle changes.

The research predicts that if all untreated eligible adults received medication, approximately 200,000 all-cause deaths and 162,000 cardiovascular deaths could be prevented over the next decade. Currently, treated patients already show a 23% lower risk of death from any cause and a 50% lower risk of heart-related death compared to untreated counterparts. Those most likely to benefit are older (average age 66) and have conditions like diabetes or chronic kidney disease. Lead author Al-Jarshawi highlighted the scale of the potential benefit, noting that over 40% of eligible patients are not receiving treatment. Senior author Mamas A. Mamas stressed that lifestyle modification remains foundational, but for those with higher risk, medication is crucial.

The study underscores the importance of the 2025 guideline’s shift toward risk-based treatment. Daniel W. Jones, chair of the guideline writing committee, emphasized that controlling blood pressure is vital for long-term health and that healthcare professionals should assess overall risk to combine lifestyle strategies with medication. The findings, published via NEWMEDIAWIRE, call for urgent action to close the treatment gap and reduce the burden of hypertension. With nearly half of eligible patients untreated, this research provides compelling evidence for broader implementation of the guideline to save lives.