This guideline covers identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with type 2 diabetes. It aims to reduce the risk of cardiovascular problems such as heart attacks and strokes by helping healthcare professionals to diagnose hypertension accurately and treat it effectively.
NICE has also produced a guideline on hypertension in pregnancy.
In November 2023, we updated our guidance on measuring and managing postural hypotension. We also added tables to the section on monitoring treatment and blood pressure targets to summarise blood pressure targets in this guideline and our guidelines on type 1 diabetes and chronic kidney disease. See update information for further details.
This guideline includes recommendations on:
- diagnosing hypertension
- starting antihypertensive drug treatment
- monitoring treatment and blood pressure targets
- choosing antihypertensive drug treatment (treatment steps 1 to 4)
- measuring blood pressure
- assessing cardiovascular risk and target organ damage
- lifestyle interventions
Who is it for?
- Healthcare professionals
- Commissioners and providers
- People who have or may have high blood pressure, their families and carers
Guideline development process
This guideline updates and replaces NICE guideline CG127. It also updates and replaces the section on blood pressure management in the NICE guideline on type 2 diabetes in adults (NG28).
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.