The British Hypertension Society is the governing body for determining care for hypertension, or high blood pressure, in the United Kingdom and is considered one of the foremost authorities on the condition worldwide. The nation's National Health Service, or NHS, and NICE, the National Institute for Health and Clinical Excellence, have collaborated to produce NHS guidelines for the diagnosis, care and prevention of hypertension.
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NHS guidelines point out that measuring hypertension means initially diagnosing a blood pressure reading of 140/90 mmHg or higher. At that time, the doctor should have the patient make two other scheduled visits for new blood pressure measurements (two each time) to see if the high blood pressure readings continue. Always measure blood pressure on the same arm and in the same place on the arm, and if they experience dizziness, measure the blood pressure with the patient standing up. If the blood pressure reading remains above 140/90, the patient has hypertension.
During the clinical consultation phase, the NHS recommends that doctors attempt to identify potential risk factors in the patient. That starts with a clinical history of the patient, including identifying a family history of diabetes or cardiovascular disease. If there is no history and the blood pressure remains raised, the doctor should identify risk factors in the patient's lifestyle that could lead to elevated blood pressure. If the patient is identified as having hypertension, the doctor should perform a formal cardiovascular risk assessment.
When determining a patient's lifestyle risks, the NHS recommends doctors look at the following: diet and exercise patterns, alcohol consumption, caffeine consumption, salt intake and smoking habits. All of these lifestyle choices, in excess, can have an adverse effect on cardiovascular health and can lead to hypertension. The doctor should offer recommendations on how to limit these risk factors.
The NHS recommends that doctors offer hypertensive patients drug therapy if their blood pressure is 160/100 mmHg or more on a persistent basis, or if the patient's blood pressure is 140/90 mmHg or more on a persistent basis and if the patient has an existing risk of cardiovascular disease. That is described as a 10-year risk of cardiovascular disease of at least 20 per cent, existing cardiovascular disease or organ damage. NHS does not recommend the use of calcium, magnesium or potassium to reduce blood pressure.
The NHS says the use of prescription medication can be valuable to patients, even if it doesn't lower their blood pressure below the 140/90 threshold for hypertension. Doctors should conduct regular reviews with patients as a way of monitoring their lifestyle choices, modifying their medication or even eliminating medication if the patient progresses to the point where it is unnecessary.
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