Unfortunately, a heart attack is not the only scary event or issue that can happen as a result of hypertension. That's why he describes the 2025 American Heart Association and American College of Cardiology blood pressure guidelines as "transformative.""Managing blood pressure is no longer just about avoiding a heart attack," Dr. Kee says. "It's about protecting your brain from dementia and your kidneys from failure."
"Hypertension is a formidable opponent, but under the 2025 guidelines, it is a manageable and preventable condition," he explains. "Through accurate detection and committed change, you have the power to protect your heart, your mind and your future."That sounds like a good foundation for a plan to prevent hypertension from getting in the way of a life you love. Dr. Kee shares how to tell when it's time to start blood pressure medication, using the most up-to-date guidance. Here's what to know before your next doctor's appointment.?SIGN UP for Parade’s health newsletter with expert-approved tips, healthy eats, exercises, news & more to help you stay healthy & feel your best self?
What Your Blood Pressure Numbers Mean
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Blood pressure category
Diastolic (bottom number)
< 120 mm Hg
Elevated
and < 80 mm Hg
130–139 mm Hg
Stage 2 hypertension
or ≥ 90 mm Hg
Now, you may look at the chart above and do a double-take. Previous guidelines put the target for healthy blood pressure at 130/80 mm Hg. Now, that's stage 1 Hypertension.
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"We now use the PREVENT calculator, a tool that estimates your 10-year risk of total cardiovascular disease—including heart failure and kidney function, which older calculators ignored," he explains. "Crucially, this tool is now used for adults starting at age 30."
Stage 1 hypertension + high risk: If you have stage 1 BP (130–139/80 9) AND a PREVENT risk 7.5% or more, diabetes, chronic kidney disease (CKD), or prior heart disease, Dr. Kee says your team will advise you to go on medication right away and make lifestyle changes.Stage 1 hypertension + low risk: "If your risk is less than 7.5%, we recommend a 3- to 6-month trial of lifestyle interventions first," he explains. "If your BP remains at or above 130/80 after this period, we start medication to prevent target organ damage."Stage 2 hypertension (≥140/90): Dr. Kee says it's best to start medication right away, regardless of your PREVENT risk score.
Now, importantly: A doctor won't diagnose hypertension based on one high reading. "A single high reading in a doctor’s office is a signal for investigation, not an automatic diagnosis," Dr. Kee says. "Blood pressure is highly variable and sensitive to your environment."
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Strategies for Lowering Blood Pressure Naturally
"Non-pharmacological therapy is the foundation of all management," Dr. Kee notes. "For many, these changes can lower blood pressure as effectively as a first-line medication."
Following a DASH eating pattern (lots of fruits and vegetables, whole grains and low-fat dairy)Lowering sodium intake (ideally 1,500 mg or under, about one teaspoon daily)Logging regular physical activity (150 minutes or moderate-intensity or 75 minutes of vigorous-intensity cardio, plus two days of resistance training per week)Maintaining a healthy weightAbstaining from alcohol use
Sometimes, your team will suggest medication. Dr. Kee says that the first four recommendations are usually:
Thiazide-type diureticsCalcium channel blockers (CCBs)ACE InhibitorsAngiotensin receptor blockers (ARBs)Remember, the goal is safety, not shame about your body or lifestyle. "Think of medication as a biological shield," Dr. Kee says. "It is not a sign of failure, but a strategic tool to keep your blood vessels young and protect your heart, brain and kidneys."
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Sources:
Dr. Patrick Kee, MD, Ph.D, a cardiologist at Vital Heart & Vein2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation.Understanding Blood Pressure Readings. American Heart Association. Top 10 Things to Know About the New AHA/ACC High Blood Pressure Guideline. American Heart Association.The American Heart Association PREVENT™ Online Calculator. American Heart Association.Shaking the Salt Habit to Lower High Blood Pressure. American Heart Association.American Heart Association Recommendations for Physical Activity in Adults and Kids. American Heart Association.Hence then, the article about i m a cardiologist here s how to know when you should go on blood pressure medication was published today ( ) and is available on Parade ( Saudi Arabia ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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