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GPs still trusted despite Shipman

NHS advisers have insisted NICE guidance on hypertension is 'national policy' and should be followed in preference to the British Hypertension Society's ABCD algorithm.

The National Prescribing Centre, in its latest MeReC briefing, told GPs they should not change practice on the basis of preliminary results from the major ASCOT trial.

ASCOT found the combination of ACE inhibitor and calcium channel blocker was significantly more effective in hypertension than a diuretic and ?-blocker.

It has been interpreted as tending to support BHS guidance over NICE.

But the briefing said: 'There is no compelling evidence that ABCD results in better cardiovascular outcomes than other approaches and it appears to have been developed without reference to cost or cost-effectiveness.'

It insisted that use of thiazide diuretics first-line, as NICE recommends, was 'at least as good as any other option...and in some aspects may be better'.

Dr Peter Fellows, chair of the GPC prescribing sub-committee, doubted whether GPs would abandon the ABCD approach. He said: 'BHS guidelines make more sense to most of us and most GPs are following BHS now. It would be nice if there was a co-ordinated approach. Hopefully they will get together and agree a common approach.'

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