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NICE consults on new hypertension draft quality standard

London, UK (October 5, 2012) – NICE has today (5 October) launched a consultation on its draft quality standard for the management of patients with hypertension. NICE quality standards aim to help commissioners, healthcare and service providers deliver the best levels of quality, evidence-based patient care. They are derived from the best available evidence (usually NICE guidance or NICE accredited sources), and apply right across the NHS in England. The draft quality standard on hypertension describes measurable markers of high-quality, cost-effective care to drive improvements in the effectiveness, safety and experience of care for people with hypertension.

Hypertension (high blood pressure) is one of the most important, but preventable, causes of premature ill health and death in the UK. It is a major risk factor for stroke, heart attack, heart failure, chronic kidney disease and cognitive decline. Raised blood pressure is one of the three main modifiable risk factors for cardiovascular disease, (along with high cholesterol and smoking), and accounts for 80% of all cases of premature coronary heart disease (CHD). Untreated hypertension is associated with a progressive rise in blood pressure. The vascular and renal damage that this may cause can culminate in a treatment-resistant state.

There are currently about 12 million people in the UK who have hypertension, (blood pressure ≥140/90mmHg) and more than half of those are over the age of 60 years. Around 5.7 million people have hypertension which is undiagnosed. As a consequence of commonplace, routine periodic screening for high blood pressure in the UK as part of the National Service Framework for cardiovascular disease prevention, the diagnosis, treatment and follow-up of patients with hypertension is one of the most common interventions in primary care, accounting for approximately 12% of primary care consultation episodes and approximately £1 billion in drug costs in 2006.

The draft quality standard on the management of hypertension has six statements to help improve care of people with hypertension. These include ensuring that people with resistant hypertension who have received four anti-hypertensive drugs and whose blood pressure remains uncontrolled are referred for specialist assessment. In addition the draft standard states that people with newly diagnosed hypertension and a 10‑year cardiovascular disease risk of 20% or higher are offered statin therapy.

The draft quality standard will be available on the NICE website for consultation, which allows stakeholders to comment and help identify which statements are most important to support service improvement.

Dr Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "The NICE clinical guideline on hypertension published last year made a number of important recommendations that are changing the way blood pressure is diagnosed for the first time in more than a century, affecting the treatment of millions of people. This new draft quality standard provides measurable markers that will drive further improvements in the management of hypertension, ensuring that it is diagnosed accurately, that treatments are provided and their adherence and efficacy monitored appropriately, and referral to specialists made when necessary."

This draft quality standard has been issued for consultation; NICE has not yet published the final quality standard to the NHS.

All eligible comments will be reviewed by the independent Topic Expert Group and the standard may be refined in light of this information. The final quality standard for hypertension is expected to be published in March 2013.

Notes to Editors

About the draft quality standard

1. The draft quality standard is available on the NICE website from Friday 5 October at: http://www.nice.org.uk/guidance/qualitystandards/indevelopment/Hypertension.jsp

The deadline for stakeholder comments is Friday 2 November.

2. More information on NICE quality standards

3. Quality standard topics are referred to NICE by ministers on the advice of the National Quality Board, a group of representatives from health and social care, committed to improving quality in the NHS and overseeing the reforms aimed at improving care. Further information on the National Quality Board.

Related NICE guidelines

4. Hypertension: clinical management of primary hypertension in adults. NICE clinical guideline 127 (2011).

5. Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. NICE clinical guideline 67 (2008).

About NICE

1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.

2. NICE produces guidance in three areas of health:

• public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies – guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

3. NICE produces standards for patient care:

• quality standards – these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework – NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients.

4. NICE provides advice and support on putting NICE guidance and standards into practice throughits implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.

This page was last updated: 04 October 2012

National Institute for Health and Clinical Excellence (NICE), 05.10.2012 (tB).