BMJ  2004;329:569-570 (4 September), doi:10.1136/bmj.329.7465.569-b

Letter

Guidelines from the British Hypertension Society

BHS is set to bankrupt NHS

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

EDITOR—If the new British Hypertension Society (BHS) guidelines¹ are evidence based I'll eat my ALLHAT.² This and other evidence points to thiazide-type diuretics as the initial treatment of choice. New US guidelines reflect this,³ but the BHS recommends a range of initial drug types for hypertension.

The BHS recommends primary prevention use of statins for those with sustained "starting" blood pressure > 140 mm Hg systolic or > 90 mm Hg diastolic, or both, and an estimated risk of cardiovascular disease > 20% over the next 10 years. The set target is to lower total cholesterol by 25% or low density lipoprotein cholesterol by 30% or to reach < 4.0 mmol/l or < 2.0 mmol/l respectively, whichever is the greater.

View larger version (56K): [in this window] [in a new window]   Blood pressure thresholds for intervention

 

Where is the evidence? The BHS cites Scandinavian cardiac outcomes trial-lipid lowering arm (ASCOT-LLA)⁴ and the heart protection study.⁵ In ASCOT-LLA subjects were . . . [Full text of this article]

Meddygfa Gyffin, Conwy, North Wales LL32 8LT martin@theduerdens.co.uk

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This article has been cited by other articles:

• Littlejohns, P., Leng, G., Sutcliffe, A. (2005). NICE responds to criticism of hypertension guidelines. BMJ 330: 309-309 [Full text]  

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