Blood Pressure Goal: 120/80 Is the Number Your Doctor Wants to See

In 2017, leading medical groups lowered the threshold for “normal” blood pressure to reduce the risk of heart attack and stroke, two of the leading causes of death in the United States and worldwide. Now, new research points to another powerful benefit of these stricter guidelines: a 15% drop in dementia risk when blood pressure is under tighter control.

A large study in rural China published in Nature Medicine showed that blood pressure below 130/80 mm Hg (millimeters of mercury) not only lowered the risk of dementia, but also reduced cognitive impairment by 16%. High blood pressure, also known as hypertension, can damage small blood vessels in the brain, and is associated with cognitive decline and memory problems. This study is the first to definitively show that lowering blood pressure to these levels can truly decrease the likelihood of dementia.

This, says Christopher Howes, MD, a Yale Medicine cardiologist, is important not only because high blood pressure is associated with many other health conditions, but because there are few proven ways to reduce the risk of dementia.

“We have some medicines that can maybe slow down the progression of Alzheimer’s disease, but we don’t have many ways to prevent dementia,” he says. “Now we have this real objective data that shows people who had high blood pressure and were on therapy for it have a lessened likelihood of dementia.”

Plus, high blood pressure is an important risk factor for coronary artery disease, Dr. Howes adds. “Treating high blood pressure and elevated cholesterol levels are two cornerstones to cardiovascular health, he says. “We have effective medications for both conditions. We need to work aggressively with our patients to achieve the desired target levels.”

Blood pressure, which is most commonly measured using a cuff wrapped around the upper arm, is the force of circulating blood against artery walls. The top, or systolic, number measures the pressure of the heart contracting. The bottom, or diastolic, figure measures the force of the heart relaxing.

Currently, the American Heart Association (AHA) and the American College of Cardiology (ACC) define normal blood pressure of systolic pressure (top number measuring the force when the heart contracts) as less than 120 and diastolic (bottom number measuring the force when the heart relaxes) as less than 80. Elevated blood pressure is 120-129/80; stage 1 hypertension is 130-139/80-89; stage 2 hypertension is 140/90 or above.

If you’re over a certain age and have been paying attention to blood pressure goals over the years, you may understandably be confused by shifting targets. Medical professionals have changed their thinking as more research has emerged about the benefits of maintaining a certain blood pressure. As a result, those numbers have been trending downward.

“The confusion over targets has been not just for patients, but for physicians, too,” Dr. Howes says.

For perspective, Dr. Howes recounts how decades ago, the unofficial advice was to add 100 to your age, and that should be your systolic blood pressure number. “This is terrifying—I remember being a young physician 30 years ago and having an 80-year-old patient tell me his blood pressure was normal because it was 180,” he says.

Then, 140/90 became the cutoff for high blood pressure embraced by experts, while 130/80 was recommended for people with diabetes or chronic kidney disease. In 2015, a large study showed that tighter control—around or below 120 systolic—significantly reduced heart attacks and strokes. In 2017, the AHA and ACC redefined high blood pressure as 130/80 or above.

“Twenty-five years ago, if someone was 140/90, we were happy. But everyone needs to get 140/90 out of our brains. It’s not a good number. That means you have high blood pressure and you need medication and we also need to start talking about lifestyle changes,” Dr. Howes says. “Because now we know that getting the blood pressure to 120/80 is ideal.”

The most recent blood pressure guideline, released in 2025 by the AHA and ACC and endorsed by 11 other health care organizations, reiterates the 2017 goals. In addition to incorporating evidence that lower blood pressure is linked to decreased dementia risk, it offers updated guidance on using medications that can benefit heart health, including the possible addition of GLP-1 agonists such as semaglutide (Ozempic) and tirzepatide (Mounjaro) in people who are overweight or obese.

The guideline offers advice on maintaining healthy blood pressure, including:

Reduce salt intake: Too much sodium in your diet leads to excess fluid and volume in your blood vessels, driving up blood pressure. The AHA recommends limiting your daily sodium intake to ideally below 1,500 mg daily. One way to do this is to consider salt substitutes that contain potassium chloride.

“Table salt is sodium chloride and is a ubiquitous product in the world. Replacing it with potassium chloride still flavors food and doesn’t have the sodium,” Dr. Howes says. “Supplementing with potassium chloride will have an incremental benefit for lowering blood pressure.”

However, Dr. Howes cautions that people who have kidney disease should speak with their physician before using potassium chloride, as they may have trouble clearing potassium from their blood.

Keep physically active: The guideline recommends increasing physical activity to at least 75 to 150 minutes each week, including aerobic exercise and/or resistance training such as lifting weights or using body weight or other methods for resistance training.

“In the past, the focus had been swimming, walking, bike riding, jogging, and while those are all still great, we now know that other activities like resistance training—think exercises such as planks and lunges—are maybe as beneficial,” Dr. Howes says.

Limit alcohol: Ideally, adults looking to lower their blood pressure should avoid alcohol altogether, the guideline says. For those who choose to drink, men should limit themselves to two drinks per day and women to one.

“There’s been a lot of discussion about alcohol in the last 12 to 18 months and there’s been a movement to decrease or eliminate alcohol consumption to lower cancer rates and hypertension,” Dr. Howes says.

Maintain or achieve a healthy weight: A goal of at least a 5% weight reduction is recommended in people who are overweight or obese. And if the weight loss is significant, people should check in with their physician, Dr. Howes advises.

“I had a patient on three medicines for his blood pressure. He came in to see me and his blood pressure was 90/60. It turned out he’d been on a weight-loss medication, too, and had lost 40 pounds, and he’d stopped drinking alcohol,” he says. “So, of course, I decreased his blood pressure medications. He’s the poster child of what the experts recommend.”