Shifting Thresholds: Changes in Antihypertensive Eligibility Under the 2025 Versus 2017 Hypertension Guidelines
Authors' conclusion
Adoption of the 2025 American College of Cardiology/American Heart Association guideline results in a minimal expansion of antihypertensive treatment eligibility. Results were robust across PREVENT model variants, supporting risk-based guideline implementation.
Study context
- Population
- U.S. adults aged 30 to 79 years in the National Health and Nutrition Examination Survey (2017–2020)weighted population 160 million
- Participants
- 5,578 adults
- Exposure
- Antihypertensive treatment eligibility under the 2025 vs 2017 guidelines
- Outcome
- Antihypertensive treatment eligibility
Methodological detailsnationally representative National Health and Nutrition Examination Survey data (2017-2020), survey-weighted estimates
- Nationally representative National Health and Nutrition Examination Survey data (2017-2020)
- Survey-weighted estimates
Main finding
As reported in the abstract
- Minimal net increase
- 0.7% (≈400,000 adults)
Observational data: associations, not effects.
Secondary outcomes
Concordance in eligibility
- Consistently ineligible
- 63.3%
- Consistently eligible
- 36.3%
Characteristics of newly eligible adults
- Predominantly older women with higher body mass index and borderline glycemic measures but without established cardiovascular disease
Eligibility patterns across racial and ethnic groups
- Stable across racial and ethnic groups
Original publication
Shifting Thresholds: Changes in Antihypertensive Eligibility Under the 2025 Versus 2017 Hypertension Guidelines. JACC Adv. Published 21 January 2026. doi:10. 1016/ j. jacadv. 2025. 102546
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