2026-01-30
Hypertension: a new threshold, a new challenge
Cardiology and Vascular Medicine
By Ana Espino | Published on January 30, 2026
| 3 min read
Hypertension (HTN) is a chronic cardiovascular disease characterized by a sustained elevation of blood pressure. It is often silent but strongly associated with severe complications, including stroke, myocardial infarction, heart failure, and chronic kidney disease. It represents one of the leading causes of preventable mortality worldwide.
Despite the availability of effective treatments, management remains suboptimal, with many undiagnosed patients, unachieved blood pressure targets, poor treatment adherence, and overly uniform approaches. In addition, treatment thresholds long set at 140/90 mmHg have often resulted in delayed intervention.
To address these limitations, a new strategy has been proposed: lowering diagnostic thresholds, integrating global cardiovascular risk into therapeutic decision-making, and strengthening individualized non-pharmacological interventions. This approach aims for earlier, more precise, and more personalized prevention.
In this context, this study was initiated to test this new strategy in order to improve the screening, evaluation, and management of hypertension in adults, with a strong focus on preventive and personalized medicine.
These recommendations are based on a systematic review of the literature evaluating diagnostic thresholds, treatment benefits, blood pressure targets, and non-pharmacological interventions. The level of evidence was graded using a standardized system (Levels A to C).
The definition of hypertension has been revised. A blood pressure of ≥130/80 mmHg (rather than 140/90 mmHg) is now considered elevated, leading to an increase in diagnosed patients, particularly among younger individuals. Cardiovascular risk stratification is incorporated to guide treatment decisions. Patients with stage 1 hypertension but high cardiovascular risk (≥10% 10-year risk) should receive pharmacological treatment, whereas others may initially benefit from intensive lifestyle modifications.
Blood pressure targets have been lowered to <130/80 mmHg for most patients, including older adults, provided treatment is well tolerated. Antihypertensive therapy should be tailored according to age, comorbidities, ethnic background, and individual tolerance.
The importance of non-pharmacological interventions is reinforced: the DASH diet, salt reduction, weight loss, regular physical activity, alcohol moderation, and smoking cessation are key pillars of blood pressure control. Finally, out-of-office blood pressure monitoring (ambulatory or home measurements) is promoted to confirm diagnosis, detect masked or white-coat hypertension, and better assess treatment effectiveness.
Hypertension is a common, silent chronic disease responsible for major cardiovascular complications. Its control remains insufficient worldwide due to late diagnosis, imperfect risk stratification, and unequal access to care.
This study aimed to reassess diagnostic thresholds and propose a preventive, personalized approach based on global cardiovascular risk. It concludes that hypertension management should start earlier, rely on more refined stratification, and systematically integrate lifestyle interventions from the earliest stages.
However, limitations remain and justify further research. Future studies will include long-term evaluations of the clinical and economic impact of the new thresholds, feasibility studies in primary care, and analyses of patient adherence strategies in the context of stricter targets. The challenge will be to confirm population-level benefits while ensuring a realistic and equitable implementation of these recommendations.
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
Hypertension (HTN) is a chronic cardiovascular disease characterized by a sustained elevation of blood pressure. It is often silent but strongly associated with severe complications, including stroke, myocardial infarction, heart failure, and chronic kidney disease. It represents one of the leading causes of preventable mortality worldwide.
Despite the availability of effective treatments, management remains suboptimal, with many undiagnosed patients, unachieved blood pressure targets, poor treatment adherence, and overly uniform approaches. In addition, treatment thresholds long set at 140/90 mmHg have often resulted in delayed intervention.
To address these limitations, a new strategy has been proposed: lowering diagnostic thresholds, integrating global cardiovascular risk into therapeutic decision-making, and strengthening individualized non-pharmacological interventions. This approach aims for earlier, more precise, and more personalized prevention.
In this context, this study was initiated to test this new strategy in order to improve the screening, evaluation, and management of hypertension in adults, with a strong focus on preventive and personalized medicine.
Should everyone aim for 130/80 mmHg?
These recommendations are based on a systematic review of the literature evaluating diagnostic thresholds, treatment benefits, blood pressure targets, and non-pharmacological interventions. The level of evidence was graded using a standardized system (Levels A to C).
The definition of hypertension has been revised. A blood pressure of ≥130/80 mmHg (rather than 140/90 mmHg) is now considered elevated, leading to an increase in diagnosed patients, particularly among younger individuals. Cardiovascular risk stratification is incorporated to guide treatment decisions. Patients with stage 1 hypertension but high cardiovascular risk (≥10% 10-year risk) should receive pharmacological treatment, whereas others may initially benefit from intensive lifestyle modifications.
Blood pressure targets have been lowered to <130/80 mmHg for most patients, including older adults, provided treatment is well tolerated. Antihypertensive therapy should be tailored according to age, comorbidities, ethnic background, and individual tolerance.
The importance of non-pharmacological interventions is reinforced: the DASH diet, salt reduction, weight loss, regular physical activity, alcohol moderation, and smoking cessation are key pillars of blood pressure control. Finally, out-of-office blood pressure monitoring (ambulatory or home measurements) is promoted to confirm diagnosis, detect masked or white-coat hypertension, and better assess treatment effectiveness.
Treat earlier, stratify better, prevent more
Hypertension is a common, silent chronic disease responsible for major cardiovascular complications. Its control remains insufficient worldwide due to late diagnosis, imperfect risk stratification, and unequal access to care.
This study aimed to reassess diagnostic thresholds and propose a preventive, personalized approach based on global cardiovascular risk. It concludes that hypertension management should start earlier, rely on more refined stratification, and systematically integrate lifestyle interventions from the earliest stages.
However, limitations remain and justify further research. Future studies will include long-term evaluations of the clinical and economic impact of the new thresholds, feasibility studies in primary care, and analyses of patient adherence strategies in the context of stricter targets. The challenge will be to confirm population-level benefits while ensuring a realistic and equitable implementation of these recommendations.
Read next: Holiday Heart: when alcohol takes control of the heart’s rhythm
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
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