Podcast - 2024 Hypertension update: NICE guideline

The video version of this podcast can be found here: • 2024 Hypertension upda...
This video makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE.
My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode, I go through the NICE guideline [NG136] on Hypertension in adults, always focusing on what is relevant in Primary Care only.
I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement.
There is a podcast version of this and other videos that you can access here:
Primary Care guidelines podcast:
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There is a UA-cam version of this and other videos that you can access here:
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The resources consulted can be found here:
Hypertension in adults: diagnosis and management - NICE guideline [NG136]:
· www.nice.org.u...
Chronic kidney disease: assessment and management - NICE guideline [NG203]:
· www.nice.org.u...
The NICE hypertension flowcharts can be found here:
· Website: www.nice.org.u...
The Full NICE guideline Hypertension in pregnancy: diagnosis and management [NG133] can be found at:
· www.nice.org.u...
The Clinic BP targets tables can be downloaded here:
· 1drv.ms/b/s!Ai...
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Transcript
If you are listening to this podcast on UA-cam, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.
Hello and welcome, I’m Fernando, a GP in the UK. Today we are going to do an up-to-date review of the NICE guidelines on hypertension, including the changes introduced in November 2023, always focusing on what is relevant in Primary Care only.
Right, so let’s jump into it.
First, this guideline does not cover specific recommendations in CKD, type 1 diabetes, or pregnancy. However, it does cover type 2 diabetes, given that the management of hypertension in type 2 diabetes is no different than in the general population.
Let’s just remind ourselves that, when checking the BP, we should always palpate the pulse first and, if there is pulse irregularity, we should measure the BP manually, because automated devices are not accurate when the pulse is irregular like in AF.
If there are symptoms of postural hypotension, like falls or dizziness:
· We will measure their BP while lying on their back (although we can consider a seated position, if inconvenient)
· And we will measure their BP again after standing for at least 1 minute.
If the systolic BP falls by 20 or more, or their diastolic BP by 10 or more:
· we will consider the causes, and review their medication
· we will manage the risk of falls
· we will check future BP readings with the patient standing and
· we will refer if necessary
Also, in order to diagnose hypertension, we will measure the BP in both arms:
· If the difference is more than 15 mmHg, more than once, we will measure subsequent BPs in the arm with the higher reading.
If BP measured in the clinic is 140/90 mmHg or higher:
· We will take a second measurement.
· If it is substantially different, we will take a third measurement and we will record the lowest of them as the clinic BP.
If clinic BP is between 140/90 mmHg and 180/120 mmHg, we will confirm hypertension by doing ambulatory BP monitoring (ABPM) or, if necessary, home BP monitoring (HBPM). While waiting, we wil...

[@cfoli7027]

Another very useful, video. Thank you

[@practicalgp]

Thank you for your comment. I really appreciate it 🙏