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Updated AHA guidelines on hypertension and dementia: defining hypertension

Kevin Hwang • 10 Mar 2026

Kevin Hwang, MD, MPH, UTHealth Houston, Houston, TX, discusses the updated guidelines from the American Heart Association (AHA) on hypertension and dementia. The new guidelines define hypertension in adults as 130 over 80 or greater, classified as stage one hypertension, and 140 over 90 or greater, classified as stage two hypertension. This interview took place on a virtual conference call with VJNeurology.

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Transcript

Well, the American Heart Association updates guidelines every couple of years. I think the last one was probably seven or eight years ago, based on new research on the prevalence of hypertension, the impact of hypertension on really important outcomes and the effect of treating hypertension on those outcomes as well. So they have a formal process for evaluating all of these things. They included dementia in this guideline as well as the one that was published in the 6th or 7th issue...

Well, the American Heart Association updates guidelines every couple of years. I think the last one was probably seven or eight years ago, based on new research on the prevalence of hypertension, the impact of hypertension on really important outcomes and the effect of treating hypertension on those outcomes as well. So they have a formal process for evaluating all of these things. They included dementia in this guideline as well as the one that was published in the 6th or 7th issue. So this guideline is defining hypertension in adults as 130 over 80 or greater. We’re calling it stage one hypertension and stage two hypertension, 140 over 90 or greater. And that is actually the same numerical definitions as was promoted in the prior guidelines. So the evidence that has come out since then, and the studies have reinforced that as being a reasonable definition for hypertension. And it is a shift for a lot of clinicians who have been practicing for a long time, where we grew up hearing about 140 or 90 as the definition of hypertension. So this would be, you know, the second iteration of the American Heart guidelines promoting 130 or 80 as the definition based on the risk of cardiovascular bad outcomes if the blood pressure is consistently above that pressure.

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