What are the guidelines for monitoring hypertension according to the National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK)?

From the Guidelines

The National Institute for Health and Care Excellence (NICE) guidelines in the UK recommend categorizing hypertension as stage 1 (BP ≥140/90 mmHg), stage 2 (BP ≥160/100 mmHg), or severe (systolic BP ≥180 mmHg or diastolic BP ≥110 mmHg), with immediate treatment for severe hypertension and initial repeat measurement using ambulatory or home BP monitoring (ABPM/HBPM) for stage 1 or 2 hypertension. The NICE guidelines provide a framework for monitoring hypertension, emphasizing the importance of accurate blood pressure measurement.

• Key aspects of the guidelines include:
  • Classification of hypertension into stage 1, stage 2, or severe hypertension
  • Recommendation for immediate treatment of severe hypertension
  • Initial repeat measurement using ABPM/HBPM for stage 1 or 2 hypertension
  • Different diagnostic BP thresholds for ABPM/HBPM, with ≥135/85 mmHg for stage 1 and ≥150/95 mmHg for stage 2
  • Consideration of additional risk factors or evidence of vascular or target organ damage for drug treatment in stage 1 hypertension According to the study published in the British Journal of Cancer 1, the NICE guidance emphasizes the importance of accurate blood pressure measurement and appropriate treatment to prevent complications.
• The guidelines prioritize the use of ABPM/HBPM to confirm the diagnosis of hypertension and to monitor treatment effectiveness. The study highlights the need for careful monitoring and management of hypertension, particularly in patients with underlying medical conditions, such as ovarian and cervical cancer receiving bevacizumab in the UK 1.
• The guidelines provide a clear framework for healthcare professionals to follow, ensuring that patients receive appropriate care and management for their hypertension. By following the NICE guidelines, healthcare professionals can help reduce the risk of complications associated with hypertension, such as heart disease and stroke, and improve patient outcomes 1.

From the Research

Guidelines for Monitoring Hypertension

The National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK) provides guidelines for monitoring hypertension. According to the available studies, the following are some key points to consider:

• The use of ambulatory blood pressure monitoring (ABPM) is recommended in clinical practice to assess out-of-office blood pressure control 2.
• Home blood pressure monitoring (HBPM) is also recommended to aid clinicians in the diagnosis and management of essential hypertension 3.
• The 2018 ESH/ESC guidelines indicate that the first-choice therapy in the majority of hypertensive patients should be a fixed combination of a drug that blocks the renin-angiotensin-aldosterone system and a calcium antagonist or a diuretic 4.
• Combination therapy with an angiotensin-converting enzyme inhibitor and a calcium channel blocker is effective in reducing cardiovascular morbidity and mortality in hypertensive patients 5, 6.

Key Recommendations

Some key recommendations for monitoring hypertension include:

• Using ABPM to assess white-coat phenomena, masked hypertension, and nocturnal hypertension 2.
• Utilizing HBPM to intensify antihypertensive therapy and improve blood pressure control 3.
• Considering the use of a fixed combination of a drug that blocks the renin-angiotensin-aldosterone system and a calcium antagonist or a diuretic as first-choice therapy in hypertensive patients 4.
• Monitoring blood pressure regularly to assess the effectiveness of treatment and make adjustments as needed 5, 6.