Hypertension in adults

Hypertension in adults-diagnosis and management. A summary of 2019 NICE guidance.

Measuring -Automated machines cannot measure accurately if a pulse irregularity exists e.g AF- use a manual method Postural hypotension is suspected♦ measure BP supine or seated♦ check again- interval atleast 1 minute with person standing♦ a drop of 20 or more , when standing reflects a postural drop- in such cases - review medication - measure subsequent bp with the person standing- refer specialist care if the symptoms of postural hypotension( e.g falls or postural

Equipment -validated , maintained and calibrated Both at home and clinic settings - standardise the environment and provide a relaxed , temperate setting person should be quiet , seated , arms outstretched and supported use the correct cuff size

Diagnosis-Hypertension diagnosis suspected-measure BP in both arms if the difference is > 15 mm hg- repeat difference persists > 15 on 2nd measurement , measure subsequent BP in the arm with the higher BP. BP equal to or > 140/90 -take a 2nd reading during the consultation 2nd reading -substantially different from 1st- take a 3rd readingrecord the lower of the last 2 measurements as the clinic bp. offer ABPM if ABPM not suitable offer...