Nearly 23 million Americans with blood pressure readings of 130/80 mm Hg or higher may be eligible for blood pressure-lowering medications according to new independent research published in the Journal of the American Heart Association.
The study evaluated the 2025 American Heart Association and American College of Cardiology guidelines regarding high blood pressure. Among 81 million U.S. adults living with high blood pressure and no established cardiovascular disease, approximately 28% may now be eligible for medical treatment.
Researchers identified a significant gap in care, noting that while 13.1 million adults are currently receiving treatment, approximately 9.7 million eligible individuals, or 43%, remain untreated. The study suggests that for those with higher cardiovascular disease risk, lifestyle modifications alone may be insufficient and should be paired with medication.
The 2025 guidelines emphasize a personalized approach to managing hypertension by considering both blood pressure levels and 10-year and 30-year cardiovascular disease risks. Healthcare providers are encouraged to use the PREVENT risk equations to assess these risks in adults aged 30 to 79. Recommended lifestyle interventions include managing weight, eating a healthy diet, increasing physical activity, reducing salt and alcohol intake, managing stress, and getting adequate sleep.
Data analysis indicated that for eligible adults, the use of blood pressure-lowering medication was associated with a 23% lower risk of death from any cause and a 50% lower risk of death from heart-related issues compared to those who do not receive treatment. If medication were extended to all eligible, untreated adults, researchers estimate that approximately 200,000 all-cause deaths and 162,000 cardiovascular deaths could be prevented over the next decade.
The individuals who would benefit most from medication are typically older, with an average age of 66, and often manage additional health conditions such as diabetes or chronic kidney disease.
While the findings highlight a massive potential for life-saving intervention, researchers noted a limitation in the study’s data. The analysis relied on blood pressure readings from single office visits collected during the National Health and Nutrition Examination Survey between 2009 and 2018, whereas current clinical guidelines recommend multiple readings across several visits to confirm a diagnosis.
