Research Helps Medical Providers Determine Best Approach to High Blood Pressure
CHAPEL HILL, N.C. – University of North Carolina researchers affiliated with the School of Nursing and School of Medicine contributed to new blood pressure guidelines released by the American Heart Association and American College of Cardiology.
Leslie Davis, PhD, RN, an Associate Professor of the UNC School of Nursing, and Sidney C. Smith, Jr., MD, Professor of Medicine at the UNC School of Medicine, are among the dozens of researchers listed in the new joint guideline.
Published in Circulation and the Journal of the American College of Cardiology (JACC), the 2025 American Heart Association (AHA) and American College of Cardiology (ACC) Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults updates national standards for diagnosing and treating high blood pressure. It replaces the 2017 AHA/ACC guideline and includes new evidence, tools and strategies aimed at improving blood pressure control through accurate measurement, consistent treatment, healthy lifestyle behaviors and patient-centered care.
High blood pressure remains the most common and preventable risk factor for heart attack and stroke. Recent research now links high blood pressure to other serious health problems, including cognitive decline, dementia and pregnancy complications like pre-eclampsia.
The 2025 AHA/ACA guideline continues to recommend a treatment goal of less than 130/80 mm Hg for adults but adds specific recommendations for people in institutional care, those with limited life expectancy and pregnant patients.
The most significant updates to the new 2025 guideline include:
- AHA PREVENT™ Risk Calculator: a new tool for estimating an individual’s risk of developing cardiovascular disease.
- Life’s Essential 8: the AHA’s updated checklist for maintaining cardiovascular health, now central to blood pressure management.
- Expanded monitoring recommendations: regular blood pressure checks for all ages, including guidance on home monitoring.
- Lifestyle and nutrition guidance: reinforced recommendations on diet, exercise and other lifestyle factors.
- Updated medication guidance: for some patients, medication is necessary for earlier treatment of high blood pressure.
- Emergency symptoms: clearer information about the signs of dangerously high blood pressure.
UNC Faculty Contributions to New Guideline
A nationally recognized expert in cardiovascular nursing, Leslie Davis is a fellow in the American College of Cardiology (ACC), the American Association of Nurse Practitioners, the American Heart Association, and the Preventive Cardiovascular Nurses Association. She is also a certified hypertension clinician through the American Society of Hypertension. Her contributions to the guideline reflect her clinical and research expertise in symptom management, patient education and long-term care for individuals with hypertension.
“In our clinic, we empower patients to take an active role in managing their blood pressure through home monitoring and shared decision-making,” Davis said. “That same approach – bringing together multiple voices and perspectives — guides the development of national clinical guidelines.”
As a member of the writing group, Davis emphasized the value of including nurse scientists. “I am honored to be part of this distinguished group of experts working to translate the latest evidence into practical recommendations,” she said. “The real impact of this work will come when clinicians and health systems implement these guidelines to improve outcomes for the patients we serve.”
Sidney Smith is a past president of both the American Heart Association and the World Heart Federation. He has extensive experience in developing cardiovascular guidelines. His leadership in past AHA/ACC recommendations on cholesterol, high blood pressure, primary prevention, acute myocardial infarction and professionalism in medicine helped shape the foundation for this latest work.
“These new guidelines recommend the latest evidence-based treatment strategies, emphasizing the importance of shared decision-making with the patient, the value of health care team involvement including physicians, nurse practitioners, and pharmacists — and home monitoring of blood pressure,” said Smith. “These three strategies will improve control of hypertension which is still the leading cardiovascular risk factor worldwide.”
For more information, access the full guideline and supporting resources through the American Heart Association newsroom and the Journal of the American College of Cardiology.