Hypertension in adults: diagnosis and management | Guidance

This guideline covers identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with ... Home NICEGuidance Conditionsanddiseases Cardiovascularconditions Hypertension Hypertensioninadults:diagnosisandmanagement NICEguideline[NG136] Published: 28August2019 Lastupdated: 18March2022 Guidance Toolsandresources Informationforthepublic Evidence History Overview Recommendations Recommendationsforresearch Rationaleandimpact Context Findingmoreinformationandcommitteedetails Updateinformation Downloadguidance(PDF) Guidance 2 Qualitystandards Airpollution:outdoorairqualityandhealth Hypertensioninadults Next Thisguidelinecoversidentifyingandtreatingprimaryhypertension(highbloodpressure)inpeopleaged18andover,includingpeoplewithtype2diabetes.Itaimstoreducetheriskofcardiovascularproblemssuchasheartattacksandstrokesbyhelpinghealthcareprofessionalstodiagnosehypertensionaccuratelyandtreatiteffectively. InMarch2022,weupdatedtheguideline.Wehave: reviewedtheevidenceandmadeanewrecommendationonbloodpressuretargetsforpeoplewhohavebothhypertensionandcardiovasculardisease. reassessedevidenceonantihypertensivedrugtreatmentfromthepreviousversionofthisguideline(withoutanewevidencereview)andmadeanewrecommendationtocoverpeoplewhohavebothhypertensionandcardiovasculardisease. Seeupdateinformationforafullexplanationofwhathasbeenupdated. NICEhasalsoproducedaguidelineonhypertensioninpregnancy. Recommendations Thisguidelineincludesrecommendationson: diagnosinghypertension startingantihypertensivedrugtreatment monitoringtreatmentandbloodpressuretargets choosingantihypertensivedrugtreatment (treatmentsteps1to4) measuringbloodpressure assessingcardiovascularriskandtargetorgandamage lifestyleinterventions Seea 2-pagevisualsummaryontherecommendationsfordiagnosingandtreatinghypertension.  Whoisitfor? Healthcareprofessionals Commissionersandproviders Peoplewhohaveormayhavehighbloodpressure,theirfamiliesandcarers Guidelinedevelopmentprocess HowwedevelopNICEguidelines ThisguidelineupdatesandreplacesNICEguidelineCG127.ItalsoupdatesandreplacesthesectiononbloodpressuremanagementintheNICEguidelineontype2diabetesinadults (NG28). Yourresponsibility TherecommendationsinthisguidelinerepresenttheviewofNICE,arrivedataftercarefulconsiderationoftheevidenceavailable.Whenexercisingtheirjudgement,professionalsandpractitionersareexpectedtotakethisguidelinefullyintoaccount,alongsidetheindividualneeds,preferencesandvaluesoftheirpatientsorthepeopleusingtheirservice.Itisnotmandatorytoapplytherecommendations,andtheguidelinedoesnotoverridetheresponsibilitytomakedecisionsappropriatetothecircumstancesoftheindividual,inconsultationwiththemandtheirfamiliesandcarersorguardian.  Allproblems(adverseevents)relatedtoamedicineormedicaldeviceusedfortreatmentorinaprocedureshouldbereportedtotheMedicinesandHealthcareproductsRegulatoryAgencyusingtheYellowCardScheme. Localcommissionersandprovidersofhealthcarehavearesponsibilitytoenabletheguidelinetobeappliedwhenindividualprofessionalsandpeopleusingserviceswishtouseit.Theyshoulddosointhecontextoflocalandnationalprioritiesforfundinganddevelopingservices,andinlightoftheirdutiestohavedueregardtotheneedtoeliminateunlawfuldiscrimination,toadvanceequalityofopportunityandtoreducehealthinequalities.Nothinginthisguidelineshouldbeinterpretedinawaythatwouldbeinconsistentwithcomplyingwiththoseduties. CommissionersandprovidershavearesponsibilitytopromoteanenvironmentallysustainablehealthandcaresystemandshouldassessandreducetheenvironmentalimpactofimplementingNICErecommendations whereverpossible. Next