Provide evidence, progress, and an occasional missed opportunity

Education and debate p 630

This issue of the BMJ includes a summary of the new British Hypertension Society guidelines for managing hypertension.1 Recently, one of the authors of these guidelines commented on the strengths of the fifth and sixth reports of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC): “The JNC reports score highly on two counts—they took note of important new evidence, and unlike the others, delivered a clear message.”2 The same can be said of this version of the British guidelines, which represent an outstanding summary of the existing evidence about the diagnosis and treatment of hypertension. In contrast to the World Health Organisation-International Society of Hypertension3 and the Joint National Committee VI guidelines,4 the brevity of this version will make the British Hypertension Society guidelines especially usefulto clinicians.

The authors aimed to produce an evidence based document, and in the full version (reference 1 in 1) they applied the North of England Group criteria to grade the evidence for most recommendations. For instance, a low dose thiazide diuretic is listed as the first line treatment for patients with uncomplicated hypertension. This evidence based recommendation, appropriately, received a grade A rating, which signifies evidence from at least one …