Excerpt

This rapid update of the NICE guideline on hypertension in primary care was undertaken because recent large clinical outcome trials had provided new information about the pharmacological treatment of hypertension. The remit was therefore very specific, focusing only on the recommendations on the pharmacological management of hypertension contained in Chapter 1.4 of the original NICE guideline. Guidance on other issues, for example the target value for starting treatment contained in recommendation 1.4.1, was not considered by this review and remains current.

The work was undertaken by the National Collaborating Centre for Chronic Conditions, based at the Royal College of Physicians of London, with two aims: to incorporate new evidence into the National Institute for Health and Clinical Excellence (NICE) guideline, and to collaborate with the British Hypertension Society (BHS) to produce new joint advice for primary care prescribers in the NHS.

Contents

• Membership of the Guideline Development Group
• 1. Pharmacological interventions
  • 1.1 Introduction
  • 1.2 Clinical evidence
  • 1.3 Health economic model
  • 1.4 From evidence to recommendations
  • 1.5 Recommendations
  • 1.6 Recommendations that are not changing
  • 1.7 Algorithm: treatment of newly diagnosed hypertension
• 2. Glossary
• 3. Search strategy
• 4. Summaries of product characteristics
• 5. Research recommendations
• 6. Audit criteria
• Appendices
  • Appendix A Forest plots
  • Appendix B Evidence tables – randomised controlled trials of pharmacological interventions
  • Appendix C Hypertension guideline –results of the economic analysis
• References

This is a pharmacological update of NICE Clinical Guideline 18 (published August 2004, see www.nice.org.uk/CG018).

The recommendations in this update replace the recommendations on pharmacological interventions for hypertension (section 1.4 of the original NICE guideline, pp103–139). No other recommendations are affected.

Acknowledgements: We would like to thank the following for their help in producing this guideline: staff at the University of Newcastle, for providing information from the 2004 NICE guideline. Joanne Lord at NICE and Anne Spencer at Queen Mary University of London, for advice on health economics. Derek Lowe at the Royal College of Physicians, for advice on meta-analysis and statistics.

Mission statement: The Royal College of Physicians plays a leading role in the delivery of high quality patient care by setting standards of medical practice and promoting clinical excellence. We provide physicians in the United Kingdom and overseas with education, training and support throughout their careers. As an independent body representing over 20,000 Fellows and Members worldwide, we advise and work with government, the public, patients and other professions to improve health and healthcare.

The National Collaborating Centre for Chronic Conditions: The National Collaborating Centre for Chronic Conditions (NCC-CC) is a collaborative, multiprofessional centre undertaking commissions to develop clinical guidance for the NHS in England and Wales. The NCC-CC was established in 2001. It is an independent body, housed within Clinical Standards Department at the Royal College of Physicians of London. The NCC-CC is funded by the National Institute for Health and Clinical Excellence (NICE) to undertake commissions for national clinical guidelines on an annual rolling programme.

Suggested citation:

National Collaborating Centre for Chronic Conditions. Hypertension: management in adults in primary care: pharmacological update. London: Royal College of Physicians, 2006.