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The British Hypertension Society has launched a stinging attack on NICE over its hypertension guidance, accusing it of being 'selective' in its use of evidence and at times 'absolutely wrong'.

NICE responded to the criticism by conceding it had been mistaken in claiming all calcium channel blockers wsere contraindicated in heart failure.

But it defended its advice on annual reviews and the treatment of black patients.

The clash is the latest chapter in a bitter feud between the organisations, sparked after NICE attacked the evidence base for the society's ABCD approach. GPs have complained they are caught in the middle and bewildered about which guidance to follow.

Professor Neil Poulter, president of the society and professor of preventive cardiovascular medicine at Imperial College, London, said NICE had made decisions on the basis of cost rather than the best clinical care.

'They used selective evidence and ignored some trials,' he told the society's primary care conference in Manchester.

Professor Poulter claimed NICE had been 'abso-bloody-lutely wrong' to claim calcium channel blockers were contra-indicated in patients with heart failure.

He also criticised the NICE guidance for failing to take into account ethnicity when selecting treatment. 'NICE are quite wrong on ethnicity ­ they have ignored the evidence,' he said.

NICE came under further fire at the conference for advising that hypertensive patients be reviewed annually, rather than every three to six months for uncontrolled hypertensives, as the society recommends.

Professor Gene Feder, professor of primary care research and development at Bart's and the London Hospital, told delegates: 'When I first read the NICE guideline, I thought they must be joking ­ it doesn't make sense for us to tell a patient with uncontrolled hypertension to come back after a year.'

Professor Feder, a GP in Hackney, east London, said he blamed a 'cock-up rather than a conspiracy' for the NICE decision.

What NICE says ­ and what's wrong with it


·All calcium channel blockers are contraindicated in heart failure.

·Offer treatment regardless of age or ethnicity

·Hypertension patients should be formally reviewed every 12 months


·NICE is 'abso-bloody-lutely' wrong!

·NICE ignored trials demonstrating differing response to classes of antihypertensive drugs in black patients

·Review period for uncontrolled hypertensives should be every three to six months

By Rob Finch

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