NICE have today published their Hypertension in Adults guidance NG136 which replaces CG127.
This provides updated guidance on the diagnosis of hypertension and measuring blood pressure. Although there are some changes since 2011, the recommendation that ABPM should be used as a preferred method of diagnosis still stands.
“Based on the evidence in the previous guideline and the committee’s experience and knowledge, it was agreed that ABPM remains the gold standard for the accurate measurement of blood pressure in primary care. ABPM has therefore been retained as the preferred method for the diagnosis of hypertension.” NG136 recommendations 1.2.1 to 1.2.5 &1.2.8
Although this recommendation was made in 2011 there is still a large variation in practice. NICE have suggested that new resources and training are needed. NG136 recommendations 1.2.1 to 1.2.5 &1.2.8
Meditech’s CardioVisions may be a solution to the training aspect. CardioVisions software works with both Meditech’s ABPM-04 and ABPM-05. Supplied by PMS Instruments it supports Windows 7, 8 &10 and is very easy to use. With colour coded trend graphs, flexible programming and data retrieval. Patient’s results are automatically classified from normal to stage 2 Hypertension.
NICE NG136 also suggests that the initial cost of using ABPM’s is outweighed by the long term benefits of accurate diagnosis and subsequent treatment. NG136 recommendations 1.2.1 to1.2.5 &1.2.8
A new guide line is the recommendation of the use of ABPM for a patient with a clinic blood pressure reading of 140/90 to180/120 to confirm hypertension.
“If clinic blood pressure is between 140/90 mmHg and 180/120 mmHg, offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension”. NG136 1.2.3
In addition there is a recommendation for the use of ABPM for patients with white-coat effect Hypertension
“Consider ABPM or HBPM, in addition to clinic blood pressure measurements, for people with hypertension identified as having a white-coat effect or masked hypertension (in which clinic and non-clinic blood pressure results are conflicting).” NG136 1.4.18
Meditech are on the list of validated blood pressure monitoring devices provided on the British and Irish Hypertension Society’s website.