Comparing hypertension guidelines

BMJ 1996;313:1203 (9 November)

Letters

Comparing hypertension guidelines

Guidelines are based on evidence from trials, not normal practice

EDITOR,--T P Fahey and T J Peters illustrate well the difficultiesthat general practitioners face in deciding whether to treathypertension, given the variation in published guidelines.¹One factor that they do not consider, however, is that the treatmentlevels set in guidelines are based on evidence from trials ratherthan measurement in normal practice.

We examined blood pressure readings in West Sussex. We expectedto find lower systolic and diastolic blood pressures than thenational average, given the recently confirmed evidence thatblood pressures in areas of low cardiovascular mortality arelower than the national average.² Instead, where we could analyseindividual readings we found that, although recorded systolicpressures in both sexes were lower (P<0.0001) than nationalvalues,³ recorded diastolic pressures in both sexes were higher(P<0.0001). Figure 1 shows the results by age group for women(n . . . [Full text of this article]

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Relevant Article

What constitutes controlled hypertension? Patient based comparison of hypertension guidelines: T P Fahey and T J Peters
BMJ 1996 313: 93-96. [Abstract] [Full Text]

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