New hypertension guideline does not recommend routine treatment for all adults over 65

Olivia Bennett
3 Min Read
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New hypertension guideline does not recommend routine treatment for all adults over 65

New hypertension guideline does not recommend routine treatment for all adults over 65
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New hypertension guideline does not recommend routine treatment for all adults over 65
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An analysis of the 2025 AHA/ACC hypertension guidelines found that under the new guidelines, about 11% of adults ages 65 to 79 with stage I hypertension would no longer qualify for blood pressure medication, a major shift from previous rules that recommended treatment for all adults in this age range. The newly exempt group is made up of generally healthy, lower-risk older adults whose predicted 10-year cardiovascular risk falls below the new treatment threshold. The analysis is published in the Annals of Internal Medicine.

Researchers from the Albert Einstein College of Medicine, Yale School of Medicine, and The Cleveland Clinic Foundation assessed how the updated 2025 hypertension guidelines, which now recommend treatment based on predicted cardiovascular risk rather than age alone, would change who qualifies for medication. Researchers analyzed national health survey data from 2013–2020 for adults ages 65 to 79, identifying those with stage I hypertension who were not already on treatment.

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They found that while all older adults in this category would have been recommended medication under previous guidelines, the new risk-based approach reclassifies about 1 in 9 as not needing immediate pharmacotherapy. These individuals were typically women in their mid-60s with otherwise low cardiovascular risk scores. The authors conclude that the updated guideline better targets treatment to those most likely to benefit and reflects a shift toward more personalized, risk-based care for older adults.

Publication details

Sridhar Mangalesh et al, Risk-Guided Antihypertensive Treatment Eligibility in Older Adults Under Updated Hypertension Guidelines, Annals of Internal Medicine (2026). DOI: 10.7326/annals-25-04519

Journal information:
Annals of Internal Medicine

Clinical categories

CardiologyPreventive medicineCommon illnesses & PreventionFamily medicineHealthy aging

Citation:
New hypertension guideline does not recommend routine treatment for all adults over 65 (2026, March 17)
retrieved 18 March 2026
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Olivia Bennett (she/her) is a health education specialist and medical writer dedicated to providing clear, evidence-based health information. She holds a strong academic background in public health and clinical sciences, with advanced training from respected institutions in the United States and the United Kingdom.   Bennett earned her Bachelor of Science in Public Health from the University of Michigan. She later completed her Doctor of Medicine (MD) at the Johns Hopkins University School of Medicine, where she developed a deep interest in preventive care and patient education.   To further strengthen her expertise in global and community health, she obtained a Master of Science in Global Health and Development from the University College London. She also completed a Postgraduate Certificate in Clinical Nutrition at the King's College London.   Since completing her studies, Bennett has worked in both clinical and health communication roles, contributing to medical blogs, health platforms, and public awareness campaigns. Her work focuses on translating complex medical research into practical guidance that everyday readers can understand and apply.   In 2021, she began specializing in digital health education, helping online health platforms maintain medically accurate, reader-friendly content. Her key areas of focus include: Preventive healthcare Women’s health Mental health awareness Chronic disease management (diabetes, hypertension) Nutrition and lifestyle medicine   Bennett believes that trustworthy health information should be accessible to everyone. Her goal is to empower readers to make informed decisions about their well-being through clear, compassionate, and research-backed guidance.   Outside of her professional work, she enjoys reading medical journals, participating in community wellness initiatives, and mentoring aspiring health writers.
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