NICE updates hypertension guidelines

The National Institute for Health and Care Excellence (NICE) has recently published its updated guidance on the diagnosis and management of hypertension in adults (NG136).

The guidance update has caused some controversy as it maintains the previous definition of hypertension as a blood pressure reading of 140/90mmHg and above. This is in difference to guidance published in 2017 by the American College of Cardiology and American Heart Association, which lowered the definition of hypertension to a blood pressure above 130/80mmHg; and the European Society of Cardiology and the European Society of Hypertension, which kept the definition of hypertension as ≥140/90mmHg but recommended that the target on treatment for patients aged <65 years was lowered to <130/80mmHg.

In the new NICE guidance, the notable change is the recommendation to initiate antihypertensive therapy in patients under 80 years that have stage I hypertension and a 10% risk of developing cardiovascular disease (CVD) within 10-years, which is a reduction from the 20% CVD risk that was recommended in the previous 2011 NICE guidance.

An article covering the new hypertension guidance and its implications for practice will be published in the November/December issue of this journal.

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