The National Institute for Health and Clinical Excellence (NICE) has recommended that GPs in England and Wales should change how they measure blood pressure in patients. The guidelines suggest the use of ambulatory monitoring of blood pressure with a device that automatically takes readings every 30 minutes throughout the day and night. The move would mean that people who are believed to have high blood pressure would have readings taken at home as a further check and to confirm the diagnosis.
NICE argue that about 25 per cent of people who have their blood pressure monitored at the doctor provide a false reading due to the stress involved, a condition known as white coat hypertension. These misdiagnoses could be costing the NHS up to GBP10.5 million on wrongly prescribed medication.
Blood pressure checks are currently based on a formal diagnosis followed by another couple of GP visits before any medication is prescribed to reduce blood pressure, although ambulatory monitoring is now being offered by about a tenth of all GPs.
A study recent published in the Lancet found that ambulatory blood pressure monitoring when high blood pressure is being diagnosed would offer improved targeting of treatment as well as being more cost effective.
It stated, “Treatment with blood pressure lowering medication is usually lifelong and so it is worth getting the decision to start right in the first place.”

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