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Hypertension in Primary care

Hypertension in Primary care. Bryan Williams Professor of Medicine Chairman NICE Hypertension Guideline Development Group Chairman BHS Hypertension Guideline Working Party. NICE clinical guideline 127. The Guideline Development Group. Evolution of NICE/BHS Hypertension Guidance.

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Hypertension in Primary care

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  1. Hypertension in Primary care Bryan Williams Professor of Medicine Chairman NICE Hypertension Guideline Development Group Chairman BHS Hypertension Guideline Working Party NICE clinical guideline 127

  2. The Guideline Development Group

  3. Evolution of NICE/BHS Hypertension Guidance 2004 – First NICE hypertension treatment guideline published 2006 - Partial Update – Pharmacological section; 5 year review process initiated in 2009; Scoping meeting February 2010; GDG Meetings throughout 2010/11; Draft Guidance for Stakeholder review; February 2011 Final guideline published August 2011 Developed in collaboration with the British Hypertension Society

  4. The Scope of the Hypertension Guidance Review The scope defines what the guideline will (and will not) examine; The scope was based on the referral from the Department of Health; The scope was also based on evidence reviews since the previous guideline; The scope was influenced by the discussions at the “scoping meeting” in February 2010.

  5. Scope of the Hypertension Guideline Partial Update 2011 Diagnosis of hypertension – what is the best method to diagnose hypertension? Treatment thresholds and Targets – when should treatment start and how low should BP be lowered? Should people over the age of 80yrs be treated? Pharmacological treatment of hypertension – what are the best drugs to use? Resistant hypertension – what is the best treatment?

  6. Guideline Development Process Full NICE Guideline Scoping Questions Evidence Search Systematic Review of Clinical Evidence NICE QRG Cost- Effective Analysis GDG Discussion Evidence-to-Recommendations

  7. Economic aspects The guideline takes into account both clinical and cost effectiveness when making recommendations involving a choice between alternative interventions. A review of the economic evidence was conducted when considered appropriate by the GDG. The preferred unit of effectiveness is the quality-adjusted life year (QALY), and the costs considered will usually only be from an NHS and personal social services (PSS) perspective. Hypertension Guideline Process

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