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NICE has provided a comprehensive set of recommendations for diagnosing hypertension - presented below is a summary of key points when you see a patient with suspected hypertension. For an overview refer to our chart on hypertension
| Diagnosing Hypertension | Recommendations |
|---|---|
| Measure blood pressure in both arms: | If the difference >15 mmHg, repeat; if still >15 mmHg, measure subsequent BP in higher arm. |
| If clinic BP is 140/90 mmHg or higher: | Take a second measurement; if different, take a third; record the lower of last 2 measurements. |
| If clinic BP is 140/90 - 180/120 mmHg: | Offer ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) if ABPM is unsuitable/unavailable or the the person is unable to tolerate |
| Carry out investigations for target organ damage, | Then assess cardiovascular risk using a risk assessment tool while awaiting hypertension diagnosis. |
| Use ABPM: At least 2 measurements per hour taken during the persons usual waking hrs | Use the average of ≥14 measurements during usual waking hours to confirm hypertension diagnosis. |
| Use HBPM: 2 consecutive measurements | - Take 2 consecutive BP measurements for each recording, with at least 1-minute interval between measurements, while the person is seated -Record twice daily ideally in the morning... |
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