In 2011, the revised National Institute for Health and Care Excellence guidelines recommended the use of ambulatory monitoring for the diagnosis of hypertension. According to a new study, the recommendation of ambulatory monitoring for hypertension diagnosis in the UK was not associated with observed negative patient outcomes.
Researchers assessed the impact of the revised guidance on the incidence of hypertension, ambulatory monitoring and cardiovascular morbidity in 3,937,191 adults from the Clinical Practice Research Datalink database with a median follow-up duration of 4.2 years.
Although the revised guidance in 2011 was not associated with an immediate change in incidence (change in rate=0.01; 95% CI, −0.18 to 0.20), it did reduce the yearly downward trend (change in yearly trend=0.093; 95% CI, 0.035-0.151). There was a significant increase in ambulatory monitoring in 2011-2012. Guideline revisions were not associated with an increase in cardiovascular events in the short-medium term.
Writing in the journal Hypertension, the authors commented: "Our results indicate that concerns that the introduction of the NICE hypertension guideline in 2011 would result in major increases in avoidable cardiovascular events and deaths, appear unfounded, at least in the short-medium term."