Up to 700,000 extra people could be advised to take anti-hypertensive medicines in a major shift of guidance published today.
According to the new guidance, drugs should be prescribed for patients with stage 1 hypertension and a relatively low risk of developing cardiovascular disease.
The risk threshold advised by the National Institute for Health and Care Excellence has been 20% over a ten-year period – but today’s advice reduces it to 10%.
NICE says it believes about 450,000 men and 270,000 women may fall into this new category – although many may already be receiving treatment.
In today’s draft guidance, NICE says it has decided not to reduce the blood pressure threshold for medication from 140/90mmhg because of the ambiguity of studies suggesting benefits from doing so.
The guidance is to be subject to consultation and will be examined closely by GP leaders.
Professor Anthony Wierzbicki, of Guy’s and St Thomas’, who led the guideline committee, said: “The guideline effectively shifts the focus to earlier intervention with lifestyle or drug treatment because this may slow the age-related deterioration of blood pressure. This would keep people well for longer and reduce the long-term need for multiple medications.
"The guideline also places a greater emphasis on achieving and maintaining blood pressure targets as many people with high blood pressure are undertreated.”
The Royal College of GPs said the new guidance would need "careful consideration."
Chair Professor Helen Stokes-Lampard said: “Lowering the threshold for making a diagnosis of hypertension, or high blood pressure – a condition that already affects a very large number of patients in the UK – is likely to affect thousands, if not millions of patients, so this decision must not be taken lightly and must be evidence-based.
“Clinical guidelines are regularly updated to take into account the most current research and make recommendations of how to implement it in the best interests of patients. Now that this draft guideline is open for consultation, we would encourage experts in the area to respond to express their views.
“We know that weight control, careful diet, and better exercise habits all remain key ways to prevent or reduce hypertension. GPs already advocate healthy lifestyle changes and discuss these with their patients where possible within the constraints of a standard 10-minute appointment."
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