New Guidelines Highlight Brain Benefits of Lowering Blood Pressure

Managing high blood pressure can cut risks for heart attack, stroke and dementia, expert groups say

Rachel Nania,

AARP

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Published August 15, 2025

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Controlling high blood pressure won’t just cut your risk of heart attack, stroke and other conditions common among the 50-plus population. New guidelines from the American Heart Association and American College of Cardiology confirm that treating high blood pressure can also lower your risk of cognitive decline and dementia.

High blood pressure can damage small blood vessels in the brain, the heart association explains, which can lead to memory problems and other cognitive issues.

“We’ve thought that lowering blood pressure would reduce the risk of dementia, but now we know with certainty and really want that to be a loud message for your audience,” says Daniel W. Jones, M.D., dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi, and chair of the guideline writing committee.

Alzheimer’s disease, the most common form of dementia, affects an estimated 7.2 million older Americans, according to the latest statistics from the Alzheimer’s Association. And heart disease is the No. 1 killer in the U.S.

High blood pressure is the leading modifiable risk factor for cardiovascular disease as well as kidney disease, Jones says. “And we now know that reducing blood pressure reduces the risk of dementia,” he adds.

Warning signs of high blood pressure

Unlike many health conditions, high blood pressure often has no symptoms, which is why it’s sometimes referred to as the silent killer.

Getting your blood pressure checked is the only way to know whether it’s high. Jones says if your blood pressure is normal (less than 120/80 mm Hg), getting it checked once a year is fine. But if it’s elevated or high, you should get it checked more often.

What is high blood pressure?

High blood pressure affects nearly half of adults in the U.S., the American Heart Association says, and is more common in older adults. Often it’s because of age-related changes in the blood vessels, the National Institute on Aging explains. (Blood pressure is the force of blood pushing against the walls of arteries, and the stiffening of those walls can cause the pressure to rise.)

Weight gain, physical inactivity, medications and underlying health conditions, such as diabetes and kidney disease, can also affect blood pressure.

According to the American Heart Association:

Normal blood pressure is anything less than 120/80 millimeters Hg (mercury)
Elevated blood pressure is 120 to 129/80 mm Hg
Stage 1 hypertension is 130 to 139 mm Hg or 80 to 89 mm Hg
Stage 2 hypertension is ≥140 mm Hg or ≥90 mm Hg

The previous blood pressure guidelines, published in 2017, recommended that people with stage 2 hypertension start medication to lower their numbers. The new guidelines, however, push for earlier intervention and recommend that if patients can’t get their blood pressure under 130 for the systolic reading, or top number, after three to six months of lifestyle adjustments, then medication should be prescribed.

“Now we have clear evidence that starting earlier, getting blood pressure down earlier in life to less than 130, is beneficial,” Jones says.

Reducing alcohol, salt and other lifestyle changes

Bad news for cocktail enthusiasts: The new guidelines advise that the best choice for managing blood pressure is to avoid alcohol altogether. For those who choose to drink, the recommendation is to limit intake to no more than two drinks per day for men and one for women.

“A little bit of alcohol intake for some patients elevates the blood pressure significantly, and so people need to be cautious about the use of alcohol,” Jones says.

A recent Gallup poll found that fewer Americans are imbibing these days, with only 54 percent of U.S. adults drinking alcohol, the lowest figure reported in the survey’s history.

Salt is another well-known culprit in rising blood pressure. The guidelines recommend that people reduce their sodium intake to 2,300 milligrams per day or, if possible, to less than 1,500 mg per day. Americans consume more than 3,300 mg of sodium per day, on average, according to the U.S. Centers for Disease Control and Prevention. Most of it comes from processed foods, not the saltshaker at home.

“One of the new tips that we have in the new blood pressure guideline is increasing the use of potassium-enriched salt substitutes. So using salt substitutes in the food that you prepare at home is one way to reduce your sodium intake,” Jones says. These products also increase potassium intake, “both of which are good for your blood pressure,” he adds.

A recent study published in JAMA found that older adults who cut about a teaspoon of salt from their daily diet — the equivalent of 2,300 mg of sodium — over one week lowered their systolic blood pressure by about 6 mm Hg, which is on par with results people see when they take a blood pressure medication.

Managing stress, exercising regularly and eating a heart-healthy diet are also key to managing blood pressure.

“Those are core things that are not going to go away, and we’re going to continue to emphasize those,” Jones says.

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