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NICE faces BP guidance row

Hypertension specialists have told Pulse of their disquiet over new NICE draft guidance sidelining thiazide diuretics and beta-blockers.

Stakeholders to the guidance are set to give NICE a rough ride during the guidance consultation period, which closes on 20 March.

The new guidance, reported in Pulse last week, prefers calcium channel blockers and ACE inhibitors first-line ­ with diuretics only suggested as alternatives.

But Dr Jonathan Mant, who will submit a consultation response on behalf of the department of general practice at the University of Birmingham, expressed concern that NICE had relied so heavily on data from the ASCOT trial.

He said: 'Some of my concern with ASCOT is that the regimen wasn't fair. There have been reviews suggesting atenolol is worse than other beta-blockers.'

Professor James Ritter, professor of clinical pharmacology at Guy's, King's College and St Thomas' Hospitals in London, said he disagreed with the downplaying of diuretics.

'I would question what evidence they had that diuretics were less effective,' said Professor Ritter, author of a new editorial in the British Journal of Clinical Pharmacology supporting use of the drugs.

The RCGP and Diabetes UK also plan to submit responses.

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