Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - August 2011

The National Institute of Health and Clinical Excellence (NICE) has published new guidance for the month of August 2011. This month there is one clinical guideline that impacts upon primary care.

The hypertension clinical guideline (QRG) replaces and updates the existing hypertension guideline that was issued in 2006. This updated guideline contains new recommendations on diagnosis, antihypertensive drug treatment and treatment monitoring.

The main differences are the recommendations to:

  • offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension (unless hypertension is severe)
  • use home blood pressure monitoring (HBPM) to confirm a diagnosis of hypertension when ABPM is not tolerated
  • treat patients with stage 1 hypertension (ABPM/HBPM ≥ 135/85 mmHg) and a 10-year cardiovascular risk equivalent to 20% or greater
  • use thiazides as a step 1 drug treatment only when calcium-channel blockers (CCBs) are contraindicated or not tolerated

Action: Clinicians should be aware of these recommendations and implement any necessary changes to practice.

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