INTRODUCTION: Hypertension, also known as high blood pressure, is the "silent killer" and may lead to more severe conditions if left unmanaged. Hypertension in service members of the U.S. military has the potential to negatively impact readiness. The aim of this study was to assess the potential impact to readiness of active duty Naval aviators and aircrew under the new 2017 ACC/AHA blood pressure guidelines.METHODS: This cross-sectional study used the Military Health System Data Repository for 2015. The population included all active duty Naval aviators and aircrew. The absolute number and proportion of those with hypertension were compared based on previous Joint National Committee 7 and 2017 ACC/AHA guidelines. Impact to readiness was calculated based on lost work days and the number of individuals with hypertension that fit the criteria to be medically grounded according to the U.S Naval Aeromedical Reference and Waiver Guide.RESULTS: Hypertension diagnoses will increase by 2904 individuals (599%) in the 23,492 Naval aviators and aircrew included in the population. Impact to readiness will result in an estimate of 510 lost work days.CONCLUSION: The 2017 ACC/AHA hypertension guidelines will lead to a dramatic increase in hypertension diagnoses in this population. Depending on the U.S. Navy disposition on hypertension, the impact can be minor or substantial, but the early opportunity for care made available with the 2017 ACC/AHA guidelines may provide long-term benefits of a healthy fighting force worth the immediate impact to readiness.Johnson MC, Banaag AL, Condie KJ, Servies TE, Pérez Koehlmoos TL. New ACC/AHA blood pressure guidelines and the operational readiness of Naval aviators and aircrew. Aerosp Med Hum Perform. 2019; 90(4):409-414.