Estiduante

Issue date: August 2011

Hypertension
Clinical management of primary
hypertension in adults
This guideline partially updates and
replaces NICE clinical guideline 34

NICE clinical guideline 127
Developed by the Newcastle Guideline Development and Research Unit and
updated by the National Clinical Guideline Centre (formerly the National
Collaborating Centre for Chronic Conditions) andthe British Hypertension Society

NICE clinical guideline 127
Hypertension: clinical management of primary hypertension in adults
Ordering information
You can download the following documents from
www.nice.org.uk/guidance/CG127
• The NICE guideline (this document) – all the recommendations.
• A quick reference guide – a summary of the recommendations for
healthcare professionals.
•‘Understanding NICE guidance’ – a summary for patients and carers.
• The full guideline – all the recommendations, details of how they were
developed, and reviews of the evidence they were based on.
For printed copies of the quick reference guide or ‘Understanding NICE
guidance’, phone NICE publications on 0845 003 7783 or email
publications@nice.org.uk and quote:
N2636 (quick reference guide)N2637 (‘Understanding NICE guidance’).

NICE clinical guidelines are recommendations about the treatment and care of
people with specific diseases and conditions in the NHS in England and
Wales.
This guidance represents the view of NICE, which was arrived at after careful
consideration of the evidence available. Healthcare professionals are
expected to take it fully into account whenexercising their clinical judgement.
However, the guidance does not override the individual responsibility of
healthcare professionals to make decisions appropriate to the circumstances
of the individual patient, in consultation with the patient and/or guardian or
carer, and informed by the summary of product characteristics of any drugs
they are considering.
Implementation of this guidance is theresponsibility of local commissioners
and/or providers. Commissioners and providers are reminded that it is their
responsibility to implement the guidance, in their local context, in light of their
duties to avoid unlawful discrimination and to have regard to promoting
equality of opportunity. Nothing in this guidance should be interpreted in a way
that would be inconsistent with compliancewith those duties.
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London WC1V 6NA
www.nice.org.uk
© National Institute for Health and Clinical Excellence, 2011. All rights reserved. This material
may be freely reproduced for educational and not-for-profit purposes. No reproduction by or
for commercial organisations, or for commercial purposes, is allowedwithout the express
written permission of NICE.

Contents
Introduction ........................................................................................................... 5
Person-centred care ............................................................................................. 6
Key priorities for implementation........................................................................... 7
1

Guidance ......................................................................................................10
1.1

Measuring blood pressure ......................................................................10

1.2

Diagnosing hypertension ........................................................................11

1.3

Assessing cardiovascular risk and targetorgan damage ........................14

1.4

Lifestyle interventions .............................................................................15

1.5

Initiating and monitoring antihypertensive drug treatment, including

blood pressure targets ......................................................................................16
1.6

Choosing antihypertensive drug...