Impact of changes to national hypertension guidelines on hypertension management and outcomes in the United Kingdom
Hypertension Jan 12, 2020
Lay-Flurrie SL, Sheppard JP, Stevens RJ, et al. - Researchers investigated how the incidence of hypertension, out-of-office monitoring and cardiovascular morbidity is influenced by the recent recommendations by national and international guidelines [revised National Institute for Health and Care Excellence (NICE) Hypertension guideline introduced in 2011] suggesting the use of out-of-office blood pressure monitoring for diagnosing hypertension. Given critics have expressed concerns this would increase cardiovascular morbidity, although there is evidence of cost-effectiveness. Experts utilized routine clinical data from English general practices, joined to inpatient hospital, mortality, and socio-economic status data. Overall 3,937,191 adults (49% men, mean age = 39.7 years) observed over a median duration of 4.2 years were analyzed between April 1, 2006 and March 31, 2017. Findings revealed a decline in the incidence of hypertension from 2.1 to 1.4 per 100 person-years across the study duration. An immediate change in incidence was not brought about by the change in guidance in 2011, but it did cause a leveling out of the downward trend. Overall, a stabilization in incidence and no increase in cardiovascular events were reported as the consequences of the changes to hypertension guidelines in 2011. Guidelines should proceed to advise out-of-office monitoring for diagnosis of hypertension.
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