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NICE hypertension guidance ‘too expensive’ to implement

NICE guidance on hypertension is too expensive to implement, and is prompting practices to encourage patients to buy their own blood pressure monitors to use at home, cardiology expert has claimed.

NICE recommended last August that ambulatory blood pressure monitoring should be used to confirm the diagnosis of hypertension in a patient with a clinical reading of 140/90 mm Hg.

But Professor Mike Kirby, a GPSI in cardiovascular disease in Letchworth, Hertfordshire, said ‘very few’ commissioning groups were funding new ABPM devices and so the guideline was proving hard to implement.

He said: ‘Very few commissioning groups are recommending enhanced service funding for it, so a lot of GPs are waiting until the machines get cheaper.’

‘The cost of equipment is going to come down, and they are waiting for it to come down; in the meantime encouraging patients to buy their own for home monitoring. What NICE says is that if you can’t do ABPM, then do home blood pressure monitoring.’

A study published last year revealed up to a third of patients in primary care with hypertension are self-monitoring their blood pressure. 

Professor Kirby said there were financial benefits for GPs and patients if they bought their own machines. ‘You save prescription costs, and the patient benefits from not receiving unnecessary medications and reduced premiums from insurance policies, if they travel.’