Update information | Hypertension in adults: diagnosis and management | Guidance | NICE (original) (raw)

November 2023: We updated recommendations 1.1.5, 1.1.6 and 1.4.16 and made 2 new recommendations (1.1.7 and 1.1.8) on how to measure and manage postural hypotension (see the February 2023 surveillance report). We also added 2 tables to the section on monitoring treatment and blood pressure targets to summarise blood pressure targets in this guideline and NICE's guidelines on type 1 diabetes and chronic kidney disease (see the November 2023 surveillance report).

March 2022: We have reviewed the evidence on blood pressure targets for people with cardiovascular disease, and made a new recommendation. This is marked [2022].

We have also reassessed the evidence on antihypertensive drug treatment, and made a new recommendation for people with cardiovascular disease. This is marked [2022].

For recommendations ending [2019, amended 2022], we have not reviewed the evidence for people without cardiovascular disease. We have made minor changes to the wording of the recommendations without changing the intent. For an explanation of these changes, see the rationale and impact section on blood pressure targets for people with cardiovascular disease.

August 2019: We have reviewed the evidence and made new recommendations on diagnosis, monitoring and drug treatment for hypertension, and identifying who to refer for same-day specialist review. These recommendations are marked [2019].

We have also made some changes without an evidence review:

• the information on cuff size for measuring blood pressure was moved to avoid repetition
• plasma glucose testing was replaced with glycated haemoglobin (HbA1C) to reflect current practice
• a note was added because of concerns about the risks of salt substitutes in some groups
• the information on when to refer to the hypertension in pregnancy guideline was made clearer.

These recommendations are marked [2004, amended 2019] or [2011, amended 2019].

Recommendations marked [2004], [2006], [2008], [2009] and [2011] last had an evidence review in that year. In some cases minor changes have been made to the wording to bring the language and style up to date, without changing the meaning.

Recommendations 1.2.11 and 1.4.24 (marked [2009]) were originally published in section 1.4 of NICE's guideline on type 2 diabetes in adults, which was updated by this guideline.

Minor changes since publication

June 2024: We corrected recommendation 1.4.26 to read 'antihypertensive' instead of 'hypertensive'.

October 2023: We corrected a link to an evidence review.

July 2022: In recommendation 1.5.1 we clarified the options for people with a blood pressure of 180/120 mmHg or more and no target organ damage.

November 2021: We added a link to the blood pressure@home scheme in recommendation 1.4.17.

December 2019: Recommendation 1.4.13 was amended to clarify that it applies to adults over 80 with stage 1 hypertension. We also made changes to introductory text to clarify that recommendations apply to all adults, including those with type 2 diabetes, unless links to other NICE guidelines indicate that treatment differs.

ISBN: 978-1-4731-5589-3