The National Institute for Health and Clinical Excellence is seeking opinion on its new blood pressure guidelines, which have undergone a major rehaul in a bid to boost the accuracy of diagnosis and save the National Health Service some cash.

The Institute has made a number of new recommendations to its original guidance in 2004 and partial update in 2006 to ensure that the latest evidence is taken into account in the diagnosis and treatment of hypertension.

In one of the biggest changes, doctors should check for the condition by monitoring blood pressure over a 24-hour period rather than the current practice of using a series of spot measurements in the clinic, as the latter method can lead to inaccurate diagnosis and a waste of NHS resources.

Alongside this, new thresholds for the diagnosis and grades of hypertension have been proposed to better reflect the outcomes of 24-hour monitoring, and targets for when to treat the condition have also been amended.

Antihypertensives should be prescribed when patients are diagnosed with stage 2 hypertension (who have an average 24-hour measurement of 150/95 mmHg or higher), as well as those with stage 2 hypertension (135/85 mmHg or higher) who also have another risk factor such as cardiovascular or renal disease, target organ damage or diabetes.

High blood pressure is widely considered one of the most important preventable causes of premature ill health and death in the UK, and is a major risk factor for a number of serious conditions, such as stroke, heart problems, chronic kidney disease and cognitive decline.

The condition already accounts for around 12% of primary care consultation episodes and more than £1 billion in drug costs, but with an ageing and fattening population the prevalence of hypertension and need for treatment will continue to rise, underscoring the need to get the management of the illness right. 

Bryan Williams, Professor of Medicine, University of Leicester and University Hospitals NHS Trust, Leicester, and Chair of the Guideline Development Group, said NICE's proposed new approach to the condition "would not only improve diagnosis but would ultimately be cost-saving for the NHS". 

New GP resource launched

Meanwhile, the Institute has also created a new section on its website to help staff in general practice get to grips with all of its guidance.  

NICE says its new resource will help to support the use of evidence-based medicine and public health practice, encouraging the uptake of national guidance in primary care and ultimately improving patient outcomes.

"It can be a real challenge to keep up-to-date with NICE guidance, but this new resource will help GPs and their staff develop a systematic approach to identifying and using NICE guidance," said Clare Gerada, Chair of the Royal College of General Practitioners.