NHS guidelines will be changed to offer blood pressure-lowering drugs to hundreds of thousands more people in the UK.

The threshold a patient has to hit before being given the life-saving drugs will be lowered and more than triple the number of people diagnosed with stage one high blood pressure.

Health service watchdog, the National Institute for Health and Care Excellence (NICE), will today issue new guidance to try and reduce heart disease deaths.

But, despite them making drugs available to more than 700,000 extra patients, campaigners accused the guidelines of not going far enough, branding them ‘conservative’ and ‘disappointing’.

As many as 18million people in the UK could be living with high blood pressure, estimates suggest, and the condition puts them at a higher risk of heart attack or stroke (stock image)

As many as 18million people in the UK could be living with high blood pressure, estimates suggest, and the condition puts them at a higher risk of heart attack or stroke (stock image)

As many as 18million people in the UK could be living with high blood pressure, estimates suggest, and the condition puts them at a higher risk of heart attack or stroke (stock image)

NICE’s announcement is a confirmation of plans revealed in March and put to public consultation before a final decision.

It will advise NHS doctors to offer medicine to high blood pressure patients who are judged to have a 10 per cent risk of developing heart disease within 10 years.

This is a relaxation from the previous 20 per cent risk threshold.

To qualify for the medications, a patient must also have a blood pressure reading of at least 140/90 – a healthy range is between 90/60 and 120/80.

The pressure readings measure millimetres of mercury (mmHg) when the heart is pushing blood out (the first number) and when it’s resting (the second number).

NICE – which advises the NHS on how to use drugs – hopes lowering the bar for medical help will reduce the numbers of people dying from heart attacks and strokes.

In 2015, high blood pressure was a contributing factor to around 75,000 deaths in the UK, and was responsible for 12 per of NHS visits and cost it £2.1billion.

But critics said NICE’s move is too weak to help people with unhealthy blood pressure.


High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

More than one in four adults in the UK have high blood pressure, although many won’t realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked.

Blood pressure is recorded with two numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They’re both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher
  • ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
  • low blood pressure is considered to be 90/60mmHg or lower
  • A blood pressure reading between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening conditions, such as:

  • heart disease
  • heart attacks
  • strokes
  • heart failure
  • peripheral arterial disease
  • aortic aneurysms
  • kidney disease
  • vascular dementia

Source: NHS

Katharine Jenner, CEO of Blood Pressure UK, said: ‘We don’t feel the guidelines go anywhere near far enough to tackle the huge numbers of people living with undetected or uncontrolled blood pressure.

‘We are disappointed that patients are still being given little say in their treatment.

‘We also feel that there should be more emphasis on home blood pressure monitoring, based on the most recent evidence.’

Around 13million people in the UK have high blood pressure, and the British Heart Foundation said a further five million may have it but not know.

Left untreated the condition can physically damage the arteries, heart and brain, and lead to heart attacks, heart failure, dementia, kidney failure or stroke.

NICE estimated that the amended guideline would lead to 450,000 more men and 270,000 more women being diagnosed with stage one high blood pressure and treated.

This will be a huge leap from the approximately 290,000 already in that category. 

People taking medicine to control the condition may take drugs called ACE inhibitors, ARBs, calcium channel blockers, diuretics or beta blockers. 

NICE spokesman Anthony Wierzbicki said in March: ‘Many people with high blood pressure don’t actually know they have it because it rarely causes any noticeable symptoms.

‘However, it is by far the biggest preventable cause of death and disability in the UK through strokes, heart attacks and heart failure.

‘A rigorous evaluation of new evidence has resulted in updated recommendations around when to treat raised blood pressure that have the potential to make a real difference to the lives of many thousands of people with the condition.’

President of the British and Irish Hypertension Society, Professor Francesco Cappuccio, said the organisation welcomed the new guideline.

But he added the BIHS ‘notes that few changes have been made to the 2011 version and finds the recommendations rather conservative compared to recent international guidelines in the US and Europe, that had reviewed the same evidence.’

He said the new rules did not improve care for high blood pressure patients who already had heart disease, who make up around a third of the patient group.

‘This is not only a missed opportunity to improve the management of hypertension in people with the highest risk,’ Professor Cappuccio said, ‘but a challenge for the implementation of the guideline in primary care.’ 

Philippa Hobson, a senior cardiac nurse at the British Heart Foundation said: ‘The latest NICE guidelines continue to show that the key lies with early diagnosis of high blood pressure and appropriate management, including medication for those who need it. 

‘This is alongside making any other recommended lifestyle changes such as increasing your physical activity to reduce the risk of heart and circulatory diseases such as heart attack and stroke.

‘The BHF is now testing new and innovative ways of allowing people to have their blood pressure checked in local communities – including testing in pharmacies or even train stations.

‘With a focus on prevention rightly at the heart of the NHS’ long term plan, we hope these guidelines will help the estimated 6 to 8 million people living with undiagnosed or uncontrolled high blood pressure across the UK.’ 

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