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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Hypertension Guideline Published

After a month delay, the National Institute for Health and Clinical Excellence (NICE) has published the Guideline for Hypertension.

The Guideline recommends using Angiotensin Converting Enzyme Inhibitors (ACEI) as first line in all patients under the age of 55. It also suggests using Calcium Channel Blockers or Thiazide Diuretics for patients aged over 55 or black patients of any age.

The BBC has reported the publication of the guideline and it is expected that media coverage will be heavy.

The Quick Reference Summary appears to have been adjusted from the draft to place Thiazide Diuretics earlier in the drug treatment algorithm.

Beta-blockers are suggested as a fourth line drugs along with alpha-blockers or further diuretic therapy. However, the guideline also suggests that if blood pressure is well controlled on a beta-blocker there is no absolute need to change therapy. It is also recommendeds that beta-blocker therapy is withdrawn gradually where appropriate.

Action: All clinicians who treat hypertension should familiarise themselves with the new guidelines and reflect on how it may change current practice.

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