Measuring blood pressure (BP) is one of the commonest tests we carry out in primary care – generally taking several measurements with a digital BP monitor on at least two clinic visits before diagnosing hypertension. Ambulatory blood pressure monitoring (ABPM) has traditionally been used in secondary care hypertension clinics, and in some larger general practices. But new guidelines from the National Institute for Health and Clinical Excellence are making ambulatory monitoring part of routine practice for the diagnosis of hypertension in primary care. What are the new guidelines recommending and why the change to ABPM?
This month’s Back to Basics focuses on the different drugs used in the management of hypertension. The wallchart provides a useful summary of the different antihypertensive drug classes and how they act to regulate blood pressure.
This useful wallchart gives at-a-glance advice on diagnosis and treatment of high blood pressure in adults, based on the most recent hypertension guidelines from NICE.
In the first 15 months of its operation, Bradford’s Healthy Hearts campaign has significantly improved the cardiovascular health of local people, and saved an estimated £1.2 m for the clinical commissioning group.
Hypertension is a silent, malevolent factor in both cardiovascular and renal disease. Raised blood pressure (BP) rarely causes any symptoms – in fact the presenting symptom of hypertension is too often the heart attack or stroke that is the end result. Diagnosis of prolonged abnormal blood pressure is therefore key in the prevention of a range of long-term conditions. In this article, we will examine the importance of measuring blood pressure correctly before making the diagnosis of hypertension. We will also look at the different levels of blood pressure that constitute a diagnosis of hypertension according to the variety of guidelines that exist.
Sleep apnoea is far more than just snoring associated with brief periods of suspended breathing while asleep. It is an important risk factor for cardiovascular disease and diabetes, so it is well worth asking patients whether they suffer breathing problems during the night and then following up those who do. More than one-third of people with sleep apnoea have hypertension, so measuring blood pressure is important in assessing risk factors and then establishing appropriate preventive treatment.
The angiotensin -receptor/neprilysin inhibitor Entresto™ (sacubitril/valsartan) is now available in the UK for treatment of adults with symptomatic chronic heart failure with reduced ejection fraction (HFrEF). The drug has been shown to have a significant mortality benefit in a head-to-head trial versus the ACE-inhibitor enalapril with an absolute risk reduction of 4.7%.
Hypertension affects one in five people in the UK and is poorly managed despite a range of drug and lifestyle interventions known to be useful and effective. We are constantly reminded about the importance of getting people to target with blood pressure (BP) treatments but this can be easier said than done. In this article, we will look at the challenge of getting blood pressure readings down to target levels and we will work through some case studies to explore possible solutions to achieving the targets in practice.
Hypertension is the most important single risk factor for cardiovascular disease (CVD). It affects over 25% of adults in England, but more than 5.5 million people remain undiagnosed. Although the number of adults with untreated hypertension has fallen, England’s performance still lags behind achievements in countries such as Canada and the USA, and there is scope for improvement.