New Guidance for Hypertension Consultation

The National Institute for Health and Care Excellence (NICE) has made a major change in the blood pressure guidance which was last published in 20111. The draft guidelines2 recommend the reduction of the threshold of hypertension treatment.

Equipment to Check Blood Pressure

Blood Pressure Monitor on doctor's desk

This means that more than 270,000 women and 450,000 men are eligible for blood pressure treatment. Therefore, an increased number of individuals would be offered drugs to lower their blood pressure as a way of preventing heart attacks and strokes. This guideline, which has been released for consultation until 30th April, is expected to be finalized in August 2019.

Previous Guidelines and New Recommendations

According to the NICE recommended guidance from 2011, drugs to reduce blood pressure should be given to individuals under the age of 80 years, who have stage one hypertension and are at a 20% or higher risk of cardiovascular disease in the next ten years.

The new recommendations suggest offering drugs to lower blood pressure to patients with a 10% or higher risk of cardiovascular disease.

Stage one hypertension is classified as having no identifiable reason behind the raised blood pressure. This may be associated with various factors, including physical activity, genetics, obesity or salt intake.

According to Anthony Wierzbicki3, the guideline committee chairman, these guideline changes have resulted in an update to the previous recommendations for early intervention of hypertension. It is expected to make a major difference in the lives of patients who suffer from hypertension.

The Reason

The recommended new guidelines will effectively shift the focus towards early intervention using either lifestyle treatment or drug treatment. It aims to reduce the age-related blood pressure issues and to help patients live a longer life, and reduce the need for taking multiple drugs.

Hypertension is one of the main causes of heart attacks and strokes in the country, however, many individuals remain undiagnosed.

Diagnosing hypertension earlier will result in earlier treatment and prevention as described in the NICE recommended guidelines. This will save the lives of thousands and also improve the quality of their lives. The new changes in guidelines aim to do this and also to improve the detection and management of hypertension over the next ten years.

These steps for preventing cardiovascular disease are important for the long term well-being and health of patients.

Concerns Regarding New Recommendations

Despite the new guidelines helping with early detection, many experts have concerns regarding the unintended harm caused by over diagnosis and over prescription of medications when the advantages may be minimal.

The majority of the population is already suffering from hypertension that has not been diagnosed, and this means they are at risk of a heart attack or stroke. It is essential therefore to increase the diagnosis rate across the country. However, it is important to ensure that these changes will enhance quality of life and not pose an increased risk to patients.


1 Hypertension in adults: diagnosis and management – National Institute for Health and Care Excellence (NICE)

2 Hypertension in adults: diagnosis and management, Draft for consultation, March 2019 – National Institute for Health and Care Excellence (NICE)

3 Thousands set to benefit from blood pressure treatment under new NICE guidance - National Institute for Health and Care Excellence (NICE)

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Last updated: Jul 3, 2019 at 3:58 AM


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