Hypertension - NICE Pathways. Your responsibility when using NICE advice. About. What is covered. This pathway covers the clinical management of primary hypertension in adults. High blood pressure (hypertension) is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for ischaemic and haemorrhagic stroke, myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension is usually associated with a progressive rise in blood pressure. The vascular and renal damage that this may cause can culminate in a treatment- resistant state. The risk associated with increasing blood pressure is continuous, with each 2 mm. Hg rise in systolic blood pressure associated with a 7% increased risk of mortality from ischaemic heart disease and a 1. Hypertension is remarkably common in the UK and the prevalence is strongly influenced by age. In any individual person, systolic and/or diastolic blood pressures may be elevated. Diastolic pressure is more commonly elevated in people younger than 5. The NICE guidelines do not list targets based solely on cholesterol levels for people with diabetes, however, cholesterol levels should be measured each year to assess risks of heart disease and other long term diabetes.With ageing, systolic hypertension becomes a more significant problem, as a result of progressive stiffening and loss of compliance of larger arteries. At least one quarter of adults (and more than half of those older than 6. Updates. Updates to this pathway. December 2. 01. 5 Minor maintenance update. October 2. 01. 5 Implanting a baroreceptor stimulation device for resistant hypertension (NICE interventional procedure guidance 5. August 2. 01. 5 Pathway restructured and summarised recommendations replaced with full recommendations. February 2. 01. 5 Minor maintenance update. July 2. 01. 4 Link to NICE pathway on cardiovascular disease prevention added. June 2. 01. 4 Link to NICE pathway on atrial fibrillation added. February 2. 01. 4 Minor maintenance updates. January 2. 01. 4 Minor maintenance updates. January 2. 01. 4 Minor maintenance updates. October 2. 01. 3 Link to NICE pathway on obesity added to this pathway. September 2. 01. 3 Minor maintenance updates. August 2. 01. 3 Quality and Outcomes Framework indicators updated in hypertension quality standard (QS2. June 2. 01. 3 Minor maintenance update. March 2. 01. 3 Hypertension quality standard (QS2. Dieta Diabetes Diabetic Care Guidelines 2014 ::The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days.. Dieta Diabetes Diabetes. Chronic Kidney Disease has now been recognised as a major public health issue. The number of patients requiring renal replacement therapy in the form of dialysis. About this resource The resource includes detailed information in. What is the DASH diet and how can it help people with high blood pressure? One of the steps your doctor may recommend to lower your high blood pressure is to start using the DASH diet. ADA 2013 nutrition guidelines for adults with diabetes, from The National Diabetes Education Initiative (NDEI) NDEI.org Premier destination for HCP diabetes education that addresses knowledge and practice gaps to enhance Home. January 2. 01. 3 Shared learning example added to supporting products. Your responsibility. Guidelines. The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this interactive flowchart is not mandatory and does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the interactive flowchart to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties. Technology appraisals. The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Medical technologies guidance, diagnostics guidance and interventional procedures guidance The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties. Person- centred care. People have the right to be involved in discussions and make informed decisions about their care, as described in your care. Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. Short Text. Clinical management of primary hypertension in adults. What is covered. This pathway covers the clinical management of primary hypertension in adults. High blood pressure (hypertension) is one of the most important preventable causes of premature morbidity and mortality in the UK. Hypertension is a major risk factor for ischaemic and haemorrhagic stroke, myocardial infarction, heart failure, chronic kidney disease, cognitive decline and premature death. Untreated hypertension is usually associated with a progressive rise in blood pressure. The vascular and renal damage that this may cause can culminate in a treatment- resistant state. The risk associated with increasing blood pressure is continuous, with each 2 mm. Hg rise in systolic blood pressure associated with a 7% increased risk of mortality from ischaemic heart disease and a 1. Hypertension is remarkably common in the UK and the prevalence is strongly influenced by age. In any individual person, systolic and/or diastolic blood pressures may be elevated. Diastolic pressure is more commonly elevated in people younger than 5. With ageing, systolic hypertension becomes a more significant problem, as a result of progressive stiffening and loss of compliance of larger arteries. At least one quarter of adults (and more than half of those older than 6. Updates. Updates to this pathway. December 2. 01. 5 Minor maintenance update. October 2. 01. 5 Implanting a baroreceptor stimulation device for resistant hypertension (NICE interventional procedure guidance 5. August 2. 01. 5 Pathway restructured and summarised recommendations replaced with full recommendations. February 2. 01. 5 Minor maintenance update. July 2. 01. 4 Link to NICE pathway on cardiovascular disease prevention added. June 2. 01. 4 Link to NICE pathway on atrial fibrillation added. February 2. 01. 4 Minor maintenance updates. January 2. 01. 4 Minor maintenance updates. January 2. 01. 4 Minor maintenance updates. October 2. 01. 3 Link to NICE pathway on obesity added to this pathway. September 2. 01. 3 Minor maintenance updates. August 2. 01. 3 Quality and Outcomes Framework indicators updated in hypertension quality standard (QS2. June 2. 01. 3 Minor maintenance update. March 2. 01. 3 Hypertension quality standard (QS2. January 2. 01. 3 Shared learning example added to supporting products. Quality standards. Quality statements. Diagnosis – ambulatory blood pressure monitoring Quality statement. People with suspected hypertension are offered ambulatory blood pressure monitoring (ABPM) to confirm a diagnosis of hypertension. Rationale. ABPM is the most accurate method for confirming a diagnosis of hypertension, and its use should reduce unnecessary treatment in people who do not have true hypertension. ABPM has also been shown to be superior to other methods of multiple blood pressure measurement for predicting blood pressure- related clinical events. Quality measure. Structure. Evidence of local arrangements to ensure people with suspected hypertension are offered ABPM to confirm a diagnosis of hypertension. Process. Proportion of people with suspected hypertension who receive ABPM to confirm a diagnosis of hypertension. Numerator – the number of people in the denominator who receive ABPM to confirm a diagnosis of hypertension. Denominator – the number of people with suspected hypertension. Description of what the quality statement means for each audience. Service providers ensure systems are in place to offer ABPM to confirm a diagnosis of hypertension. Healthcare professionals offer ABPM to confirm a diagnosis of hypertension. Systolic and diastolic pressure readings are deduced from the shape of oscillometric pressure changes using an algorithm built into the measuring device.
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