FEATURED EDITORIAL
Will generic hypertension guidelines reduce the proliferation of directives?
1 Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
2 The Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
Correspondence to:
Correspondence to:
Dr Jan A Staessen
Studies Coordinating Centre, Laboratory of Hypertension, Campus Gasthuisberg, Herestraat 49, Box 702, B-3000 Leuven, Belgium; jan.staessen@med.kuleuven.be
"...practitioners should realise that recommendations can never replace sound clinical judgment or take precedence over the personal interaction between patient and doctor"
Abbreviations: ABPM, ambulatory blood pressure monitoring; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin type 1 receptor blocker; CCB, calcium-channel blocker; NICE, National Institute for Health and Clinical Excellence
| The first 150 words of the full text of this article appear below. |
The National Institute for Health and Clinical Excellence (NICE)1 and the Joint British Societies2 recently updated their recommendations for the management of hypertension. This short editorial commentary reviews some aspects of these guidelines1,2 against the background of other directives3–6 and identifies some areas of discrepancy that need further reflection. A detailed overview of the literature falls beyond the scope of this commentary, but references supporting our views are available in the guideline documents1,2,4–6 or in our previous publications.7–9
The management of hypertension rests on the accurate assessment of blood pressure. Compared to conventional blood pressure measurement, automated techniques of recording, especially ambulatory blood pressure monitoring (ABPM), provide a more precise estimate of a patient’s usual blood pressure, exclude observer bias, minimise the white-coat effect, and refine risk stratification.10 In addition, ABPM gives information on the diurnal blood pressure pattern, the efficacy of 24 h blood pressure control, and the presence
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