Faculty members from the University of North Carolina School of Nursing and School of Medicine have played a role in developing new blood pressure guidelines released by the American Heart Association (AHA) and American College of Cardiology (ACC).
Leslie Davis, PhD, RN, an associate professor at the UNC School of Nursing, and Sidney C. Smith, Jr., MD, professor at the UNC School of Medicine, are among those who contributed to these updated recommendations. The 2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults was published in Circulation and the Journal of the American College of Cardiology.
The guideline replaces previous standards set in 2017 and incorporates new evidence as well as updated strategies aimed at better blood pressure control. Key updates include a continued treatment goal for adults to maintain blood pressure below 130/80 mm Hg. There are also new specific recommendations for individuals living in institutional settings, people with limited life expectancy, and pregnant patients.
The guideline introduces several changes: it features the AHA PREVENT Risk Calculator to estimate cardiovascular disease risk; places Life’s Essential 8—a checklist for heart health—at the center of blood pressure management; expands recommendations on monitoring across all age groups including home checks; reinforces guidance on diet and exercise; updates when medications should be started; and provides clearer information about emergency symptoms related to high blood pressure.
High blood pressure remains a major preventable risk factor for heart attack and stroke. Research now links hypertension not only to cardiovascular disease but also cognitive decline, dementia, and pregnancy complications such as pre-eclampsia.
Leslie Davis is recognized nationally for her work in cardiovascular nursing. She is a fellow in multiple organizations including the ACC and AHA. Her expertise includes symptom management, patient education, and long-term care for people 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 part of the writing group behind this update, Davis noted her appreciation for nurse scientists’ involvement: “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 has previously served as president both at AHA and World Heart Federation. He has been involved with earlier guidelines addressing cholesterol management as well as high blood pressure treatment.
“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.”
