New blood pressure guidelines stress early control

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Managing hypertension may lower dementia risk

A new 2025 high blood pressure guideline from the American Heart Association (AHA) and the American College of Cardiology (ACC) calls for earlier prevention and tighter control of hypertension to reduce the risk of heart attack, stroke, kidney disease — and even dementia.

According to the updated recommendations, intensive blood pressure management can reduce the risk of dementia by 12 to 19%.

That makes early detection and control a key public health issue, especially in Kansas, where nearly one in three adults—about 33 percent—have been diagnosed with high blood pressure. Many more may be living with the condition unknowingly.

“It’s really about tighter management,” said Dr. Bill Short, affiliate physician executive, at Memorial Health System.

“The latest guidelines are lowering the goals for treatment recommendations, especially for people who already have risk factors for heart or kidney disease. We can help people live longer if we manage their blood pressure a little more aggressively.”

The new guideline defines normal blood pressure as less than 130 over 80, and for higher-risk patients, physicians may aim for a systolic pressure closer to 120 if tolerated.

To reach these goals, Short said lifestyle changes remain the first line of defense.

“People should be monitoring their blood pressure regularly and making lifestyle modifications—losing weight if needed, following a sodium-restricted diet, limiting alcohol, getting regular physical activity,” he said. “A DASH or Mediterranean diet can also be very helpful.”

If lifestyle changes aren’t enough to reach target levels, Dr. Short said patients should work with their doctor to discuss medication options.

“If it’s high and those lifestyle modifications don’t get you to the goal, then initiating medication is recommended,” he said.

When it comes to getting started with healthy habits, Short recommends beginning small and using tools that make change easier.

“There are lots of apps you can get on your phone to help you track your activity or your diet,” he said.

“Even walking for 30 minutes several times a week can be helpful.

The key is starting at a level that’s comfortable and working your way up. Checking your blood pressure regularly is one of the simplest things you can do for your health. It’s a small step that can make a big difference.”

For more information about the new guidelines and resources to manage blood pressure, visit heart.org.

What Is the

DASH Diet?

Developed through research funded by the National Heart, Lung, and Blood Institute, the DASH diet, short for Dietary Approaches to Stop Hypertension, is designed to lower blood pressure and improve heart health.

It emphasizes:

• Fruits and vegetables: rich in potassium, magnesium, and fiber

• Whole grains: such as oats, brown rice, and whole wheat

• Lean proteins: like poultry, fish, and beans

• Low-fat dairy: for calcium and protein

• Limited sodium, sugar, and saturated fat: by reducing processed foods, red meat, and sugary drinks

Studies show the DASH diet can help lower blood pressure and improve heart health, often within just a few weeks.

DASH guidelines recommend limiting sodium to 1,500–2,300 milligrams per day and focusing on balanced meals with plenty of plant-based foods.

According to a study published on the National Library of Medicine website, research shows the DASH diet can help lower blood pressure, reduce LDL cholesterol, and lower the risk of heart disease and stroke—often within just a few weeks.

What Is the

Mediterranean Diet?

The Mediterranean diet is based on the traditional eating patterns of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain.

Research supported by the American Heart Association and Harvard School of Public Health shows it can help lower blood pressure, improve cholesterol, and reduce the risk of heart disease and stroke.

It emphasizes:

• Fruits and vegetables: eaten daily and in generous portions

• Whole grains and legumes: like brown rice, lentils, and chickpeas

• Healthy fats: especially olive oil, nuts, and seeds

• Lean proteins: mainly fish and poultry, with limited red meat

• Moderate dairy and red wine (optional): often enjoyed in small amounts with meals

The Mediterranean diet promotes long-term heart health through balanced, plant-forward eating, nutrient-rich foods, and healthy fats. It also encourages mindful eating, social mealtimes, and an overall active lifestyle—key habits that contribute to improved cardiovascular and cognitive health.

How blood pressure affects

brain health

Research increasingly shows that high blood pressure can raise the risk of dementia, including Alzheimer’s disease and vascular dementia.

Hypertension damages blood vessels throughout the body, including those in the brain, reducing blood flow and contributing to small strokes and other forms of vascular injury. Over time, these changes can lead to memory loss and cognitive decline.

According to the National Institute on Aging, maintaining healthy blood pressure helps protect brain function, especially in midlife, when hypertension is most likely to start causing long-term effects.

The SPRINT MIND study, a clinical trial supported by the National Institutes of Health, found that intensive blood pressure control (targeting a systolic pressure below 120 mm Hg) reduced the risk of developing mild cognitive impairment, often a precursor to dementia, by 19% compared with standard treatment.

Experts say that managing blood pressure through diet, exercise, stress control, and medication when needed not only protects the heart but also helps preserve memory and thinking skills well into older age.