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NICE has published its draft updated guideline on the diagnosis and treatment of high blood pressure (hypertension) for public consultation.

In the biggest change to NICE’s previous guidance published in 2011, the level of a person’s cardiovascular disease risk at which treatment for high blood pressure can be started has been reduced.

The draft guideline recommends that blood pressure-lowering drugs should be offered to people aged under 80 with a diagnosis of stage one hypertension who have a 10 per cent or greater risk of developing cardiovascular disease within the next 10 years.

It’s estimated that around 450,000 men and 270,000 women would fall into this category. However, it is likely that the impact of the new recommendations will in fact be lower as some estimates suggest half of people in this category are already receiving treatment.

The draft guideline also considered new studies suggesting that people with blood pressure below the level at which high blood pressure is usually diagnosed (140 / 90mmHg) might also benefit from medication. It also looked at what the effect would be of lowering the blood pressure target for people on treatment.

However, some of these studies, which formed a key part of the evidence reviewed in other recent international hypertension guidelines, were difficult to interpret because they included people who had other conditions that would also raise their cardiovascular disease risk, such as chronic kidney disease. Therefore, these studies could not be directly used to inform the recommendations in this draft guidance.

Anthony Wierzbicki, Consultant in Metabolic Medicine / Chemical Pathology, and Chair of the Guideline Committee, said, ‘Many people with high blood pressure don’t actually know they have it because it rarely causes any noticeable symptoms. However, it is by far the biggest preventable cause of death and disability in the UK through strokes, heart attacks and heart failure. A rigorous evaluation of new evidence has resulted in updated recommendations around when to treat raised blood pressure that have the potential to make a real difference to the lives of many thousands of people with the condition.’

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