Interpretation of the 2025 AHA/ACC hypertension guidelines: new perspectives on hypertension prevention and management

Hypertension, the leading risk factor for cardiovascular diseases worldwide, has shown a continuously expanding prevalence and a distinct younger trend, emerging as a major public health challenge. Scientific optimization of its prevention and treatment strategies is crucial for significantly reducing the morbidity and mortality burdens of stroke, coronary heart disease, and chronic kidney disease. In August 2025, the American Heart Association (AHA) and the American College of Cardiology (ACC) jointly released the first major update to the guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults since 2017. This update is based on new evidence from recent evidence-based medicine and addresses the emerging clinical needs amid the global hypertension epidemic. This article systematically summarizes the core updated content of the guideline, compares the key differences between this version and the 2017 edition from five dimensions-hypertension definition and classification, risk stratification tools, timing of treatment initiation, pharmacological selection strategies, and blood pressure control targets-and interprets the rationale behind the updates in light of evidence-based data. Additionally, targeting general practice settings, it proposes scientific and operable recommendations for guideline application, providing practical references for clinicians to accurately implement the guideline and achieve individualized hypertension management, thereby facilitating the further improvement of hypertension prevention and treatment outcomes.