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In order to call and recall patients effectively and in order to be able to report on indicators for hypertension, practices must be able to identify their population of patients who have established hypertension. A number of patients may be wrongly coded in this group, for example patients who have had one-off high blood pressure readings or women who have been hypertensive in pregnancy.
The British Hypertension Society recommends that drug therapy should be started in all patients with sustained systolic blood pressures of greater than or equal to 160 mmHg or sustained diastolic blood pressures of greater than or equal to 100 mmHg despite non-pharmacological measures.
Drug treatment is also indicated in patients with sustained systolic blood pressures of 140–159 mmHg or diastolic pressures of 90–99 mmHg if target organ damage is present or there is evidence of established cardiovascular disease or diabetes or the ten-year risk of CHD is raised.
Elevated blood pressure readings of greater than 140/90 on three separate occasions are generally taken to confirm sustained high blood pressure.
Further information:
British Hypertension Society Guidelines (2004). www.bhsoc.org
(see guidelines). The routine surveillance of the patient population for hypertension
is dealt with in the organisational indicators.
NICE clinical guideline 34 (2006). Hypertension. Management of hypertension in adults in primary care. http://guidance.nice.org.uk/CG34
NICE public health guidance 25 (2010). Prevention of CVD.
http://guidance.nice.org.uk/PH25/Guidance/pdf/English
The practice reports the number of patients on its hypertension disease register and the number of patients on its hypertension register as a proportion of total list size.
Verification – PCOs may compare the expected prevalence with the reported prevalence.
Prepared By Jean Keenan