British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary

doi:10.1136/bmj.328.7440.634

BMJ 2004;328:634-640 (13 March), doi:10.1136/bmj.328.7440.634

Education and debate

British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary

Bryan Williams, professor of medicine¹, Neil R Poulter, professor of preventive cardiovascular medicine², Morris J Brown, professor of clinical pharmacology³, Mark Davis, general practitioner⁴, Gordon T McInnes, professor of clinical pharmacology⁵, John F Potter, professor of ageing and stroke medicine⁶, Peter S Sever, professor of clinical pharmacology², Simon McG Thom, reader in medicine², the BHS guidelines working party, for the British Hypertension Society

¹ Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, ² International Centre for Circulatory Health, Imperial College London and St Mary's Hospital, London, ³ Clinical Pharmacology Unit, Addenbrooke's Hospital, University of Cambridge, Cambridge, ⁴ Moorfield House Surgery, Garforth, Leeds, ⁵ Section of Clinical Pharmacology and Stroke Medicine, Division of Cardiovascular and Medical Sciences, Gardiner Institute, Western Infirmary, University of Glasgow, Glasgow, ⁶ continued over Ageing and Stroke Medicine Section, Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester

Correspondence to: B Williams bw17@le.ac.uk

The first 150 words of the full text of this article appear below.

Much new evidence has emerged on the importance of blood pressureas a risk factor for cardiovascular disease; the importanceof lifestyle measures for the prevention and treatment of hypertension;the efficacy and safety of different drug classes; managementof hypertension in groups at higher risk, including people withdiabetes; the importance of assessing the total risk of cardiovasculardisease; and additional benefits associated with the use ofstatins.

Concern remains that national surveys continue to show substantialunderdiagnosis, undertreatment, and poor rates of blood pressurecontrol in the United Kingdom.¹ A key reason for this is thepredominant use of monotherapy by most doctors.¹ To improvethis suboptimal treatment, the British Hypertension Societyrecommends a treatment algorithm based on the AB/CD rule.²

Treatment of blood pressure alone will leave many hypertensivepatients at unacceptably high risk of cardiovascular complicationsand death. This guideline reinforces the view that doctors should. . . [Full text of this article]

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