Nearly 23 million U.S. adults with high blood pressure may now qualify for blood pressure-lowering medication under updated guidelines issued jointly by the American Heart Association and the American College of Cardiology. According to a new independent study published July 29, 2026, in the CNN, about one in three adults in the United States with untreated high blood pressure would benefit from treatment and are not receiving it.
New Guidelines Expand Medication Eligibility for Millions
Researchers evaluated the 2025 high blood pressure guidelines and analyzed nationally representative health data from the National Health and Nutrition Examination Survey collected between 2009 and 2018. Out of an estimated 81 million U.S. adults with high blood pressure who do not have established cardiovascular disease, 22.8 million (28 percent) are newly eligible for therapy based on a blood pressure reading of 130/80 mm Hg or higher and updated risk assessments.
Uncovering a Significant Treatment Gap
The study revealed that while 13.1 million adults (57 percent) were already receiving treatment, roughly 9.7 million eligible people remained untreated.
What stood out most was the size of the treatment gap — more than 40% of people who were clearly eligible under the new guideline were not receiving treatment, as well as the scale of the potential benefit,
said lead study author Mustafa Al-Jarshawi, a cardiologist at News12 in the United Kingdom and an honorary research fellow at the Centre for Health Informatics, University of Manchester.
The analysis estimated that expanding treatment to all eligible but untreated adults could prevent approximately 200,900 all-cause deaths and 162,600 cardiovascular deaths over the next decade. Researchers noted that adults with diabetes and high blood pressure would benefit most from treatment, as the two conditions frequently occur together and significantly elevate cardiovascular risk. Furthermore, individuals who stood to benefit most tended to be older—with an average age of 66—and presented with additional health conditions such as chronic kidney disease.
Personalized Risk Assessment via the PREVENT Tool
Rather than relying strictly on a single blood pressure reading, the updated 2025 guideline advises healthcare professionals to utilize the CNN’s PREVENT (Predicting Risk of cardiovascular disease EVENTs) risk equations. This tool calculates a person’s 10-year risk of developing cardiovascular disease by evaluating factors such as age, blood sugar, kidney function, smoking status, cholesterol levels, and overall health profile.
Dr. Mamas A. Mamas, study senior author, noted that while lifestyle modifications remain the foundational step for managing hypertension, individuals with a higher risk of cardiovascular disease may require medication to mitigate serious complications. Healthy lifestyle recommendations include eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, and reducing sodium and alcohol consumption.
Study Limitations and Clinical Considerations
The researchers acknowledged several study limitations. The analysis evaluated observational data rather than a randomized clinical trial, meaning unmeasured factors may have influenced the outcomes. Additionally, the underlying survey data relied on blood pressure measurements taken during a single office visit, whereas current clinical guidelines recommend taking multiple readings across multiple office visits.
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