The management of hypertension in primary care: updated guidance from NICE
Volume 17 Number 1
September 2006

Summary  This Bulletin provides an update on the management of hypertension in primary care following publication of MeReC Briefing No. 29 on this topic in April 2005 and issue of the updated NICE clinical guideline CG034 in June 2006. The Bulletin is in several parts, each of which can be downloaded separately as printer-friendly documents: Part 1 — a quick 2 page summary of the key points Part 2 — a more detailed overview of the management of hypertension, including sections on risk assessment, measurement of blood pressure, treatment thresholds and targets, lifestyle interventions, and drug treatment Part 3 — a more detailed review and critique of the recent update to the NICE guidelines regarding the drug treatment of hypertension. Alternatively, Click here to print the Bulletin as one document (large PDF file size).

Contents

Part 1. Key points

Part 2. An overview of the management of hypertension

• Introduction
• What is hypertension and why is it important?
• How should BP be measured?
• Ambulatory BP monitoring (ABPM)
• Cardiovascular risk and preventative measures
• What are treatment thresholds and targets for BP?
• Lifestyle interventions
• Drug treatment of hypertension
• What does the updated NICE guideline recommend?
• What about the previous concerns over CCBs?
• What about AIIRAs?
• What about α-blockers?
• What about patients with diabetes and hypertension?
• What about black patients/ethnic minorities?
• What about patients with isolated systolic hypertension (ISH)?
• What about very elderly people?
• What about adverse effects?
• Cost impact of the updated NICE guideline
• Drug costs and other information
• Treatment from the patient’s perspective
• Key points for PCTs and prescribers

Part 3. A review and critique of the updated NICE guideline for drug treatment of hypertension

• Why was there a need to update the NICE guideline?
• How were the updated guidelines developed?
• How do the changes for drug treatment compare with the 2004 guideline?
• Clinical effectiveness
• Economic analysis
• Why may some of the changes be contentious?

References

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