High blood pressure treatment could prevent 200,000 deaths over next decade in USA

Offering high blood pressure treatment to more people could prevent around 200,000 deaths over the next decade in the USA, Keele researchers have said, after their study revealed that not everyone who is eligible is accessing treatment. 

An international research team led by Dr Mustafa Al-Jarshawi, an NIHR Academic Clinical Fellow in Cardiology at Keele, found that despite changes to national guidelines in the USA which made more adults eligible to receive therapy to treat high blood pressure, there was still a high proportion of eligible patients who had not accessed the treatment. 

Guidelines in the US were changed in August 2025 after the American Heart Association and American College of Cardiology released new guidance for the treatment of hypertension (high blood pressure). 

The guidelines recommended that antihypertensive therapy be offered to patients with high blood pressure coupled with diabetes, chronic kidney disease, or those at higher risk of cardiovascular disease based on the AHA’s PREVENT calculator, which uses common clinical information to estimate cardiovascular disease risk.  

But even though nearly one in three US adults with hypertension are eligible for therapy under the new guideline, more than two in five do not receive the treatment.  

To study how effective these treatments are, the research team looked at health data from 81 million Americans with hypertension, spanning a period from 2009-2018. Of these, 22.8 million of them were eligible for therapy under the newly introduced guidelines, with 13.1 million of them receiving treatment. 

Their analysis, published in the Journal of the American Heart Association, found that antihypertensive therapy was associated with a 23% reduction in mortality from any cause, and a 50% reduction in mortality from cardiovascular disease. Adults with diabetes were seen to have the greatest benefit. 

The researchers have called for more eligible people to be offered the treatment, saying that extending treatment to all eligible adults could prevent more than 200,000 all-cause and 160,000 cardiovascular deaths in the USA over the next decade. 

Dr Mustafa Al-Jarshawi said: “What we found is that about 1 in 3 people with high blood pressure would now be eligible for treatment, but many of them are not receiving it. Using national data, we estimated that if all eligible people were treated, this could prevent hundreds of thousands of deaths over the next 10 years.  

“In simple terms, treating high blood pressure earlier—especially in people at higher risk—could save a large number of lives, but there is still a significant gap between guidelines and what happens in real-world care.” 

Professor Mamas Mamas from Keele University added: “The next step for our research is to build on these findings by exploring how longer-term risk assessment could further improve treatment decisions. Specifically, we are currently studying the use of the 30-year PREVENT risk model in hypertension. While recent dyslipidaemia guidelines recommend using both 10- and 30-year risk estimates, there is limited evidence on how 30-year risk could be applied to guide antihypertensive treatment decisions.”