Hypertension is the most important single risk factor for cardiovascular disease (CVD). It affects over 25% of adults in England, but more than 5.5 million people remain undiagnosed. Although the number of adults with untreated hypertension has fallen, England’s performance still lags behind achievements in countries such as Canada and the USA, and there is scope for improvement.
This useful wallchart gives at-a-glance advice on diagnosis and treatment of high blood pressure in adults, based on the most recent hypertension guidelines from NICE.
The first Health Survey England (HSE) in 1994 revealed a ‘rule of halves’ since only half of people with hypertension were diagnosed, of which half were treated and of those, only half were controlled. Have matters improved over the more than 20 years since the first HSE survey?
Over the next 10 years, an estimated 45,000 quality-adjusted life-years and £850m health and social care costs could be saved, if England saw a 5 mmHg reduction in the average population systolic blood pressure. In addition, substantial reductions in death and disability could be achieved if there was a step change in our approach to detection and treatment of hypertension. This is the rationale behind the Blood Pressure Action Plan that was published recently.
NICE now recommends that 24-hour ambulatory blood pressure monitoring (ABPM) rather than repeat clinic measurements should be the gold-standard test for diagnosing high blood pressure. This article considers the practicalities of using ABPM in the clinic, including advice to pass on to patients to ensure accurate readings.
Since the publication of the National Institute for Health and Clinical Excellence (NICE) clinical guidance (CG 127) on the management of hypertension in adults two years ago, new evidence has been published which is relevant to – and potentially has an impact on – the guideline recommendations. This evidence is presented and reviewed in the following article.
We evaluated the accuracy and predictive value of conventional BP measurements performed by primary care physicians in comparison with ABPM in a cross-sectional study of hypertensive patients in primary healthcare. We found that conventional BP measurements are less accurate than 24-hour ABPM.
High blood pressure is undoubtedly the major modifiable risk factor for cardiovascular disease (CVD). However, despite advances in management, it remains inadequately managed. Across Europe, only about one in four of treated patients achieve guideline-recommended targets for blood pressure. This has important consequences for increasing the risk of CVD, kidney disease, microvascular disease, as well […]