Critical and Comparative Analysis of the 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for Hypertension and Other International Guides and Protocols

The 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation, and management of arterial hypertension introduces important updates compared with the 2017 version. Given the global impact of hypertension as a major cause of cardiovascular morbidity and mortality, and the coexistence of multiple international and national recommendations, the Mexican Expert Group on Arterial Hypertension (GREHTA) conducted a structured review and comparative analysis. We contrasted the 2025 AHA/ACC recommendations with those of the European Society of Hypertension (ESH 2023), the European Society of Cardiology (ESC 2024), the Latin American Society of Hypertension (LASH 2024), and the National Medical Care Protocol of Mexico (PRONAM 2025). Our goal is to provide clinicians with a clear, evidence-based synthesis to guide practical decision-making. Key topics include definitions and thresholds, diagnostic methods, cardiovascular risk stratification, therapeutic strategies, special populations, and resistant hypertension. GREHTA emphasizes a pragmatic, regionally adapted approach, highlighting early combination therapy, risk factor integration, and systematic follow-up.