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NICE to consider a lower threshold for diagnosing high blood pressure

After the US lowered the cut-off for diagnosing and treating high blood pressure from 140 to 130mmHg systolic, the UK could be set to follow suit

 

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The National Institute for Health and Care Excellence (NICE) will consider lowering the cut-off points for diagnosing and treating high blood pressure as they update their guidelines on high blood pressure. The possible change comes after the US lower their target blood pressure in a bid to prevent heart attacks and strokes.

A lower target blood pressure would mean millions more Brits fall into the high blood pressure category and many could be prescribed medications to help keep it under control.

What are the NICE Guidelines?

The NICE committee produce guidelines for GPs and other health professionals to use in diagnosing and treating their patients. NICE last updated their guidelines for high blood pressure in 2011 and are due to publish a new update in August next year, after releasing a draft version for consultation early in 2019.   

The current guidelines recommend a threshold for diagnosing stage 1 high blood pressure of 140/90mmHg in clinic or 135/85mmHg using home monitoring techniques. Stage 2 high blood pressure is 160/100mmHg in clinic or 150/95mmHg at home. Doctors are advised to offer treatments to people of any age with stage 2 high blood pressure, and for some patients with stage 1.

Why are NICE considering changing the guidelines?

In November of last year, the American College of Cardiology and the American Heart Association published guidelines lowering the level for diagnosing stage 1 high blood pressure from 140/90mmHg to 130/80mmHg, putting almost half of Americans in the high blood pressure category.

The guidelines were changed after the SPRINT study, published in 2016, showed that lowering systolic blood pressure to 120mmHg rather than 140mmHg reduced the risk of heart disease and stroke by a quarter.

NICE have commented: “we are asking some of the same questions being considered in the US and in doing so will be considering some of the same evidence.”

What would a change in the guidelines mean?

At the moment, a third of adults in the UK have high blood pressure. A lower cut-off point for diagnosing and treating high blood pressure would mean millions more people fall into the high blood pressure category, and millions would move from stage 1 to stage 2 and could be offered treatment with medications on top of lifestyle advice.

Professor Graham MacGregor, Chairman of Blood Pressure UK says: “Eating less salt, more fruit and vegetables, taking more exercise and keeping to a healthy weight will help you stay healthier and prevent strokes and heart disease. Nevertheless some patients will need to be on tablets in order to be in control of their blood pressure.

High blood pressure kills thousands of people every year in the UK and is almost entirely preventable. As an individual having your blood pressure checked is the most important step that you can take to reduce your risk of stroke, heart attack or heart failure.”

 

Read more

See the current NICE guidelines

Read about the change in the US guidelines