Quality statement 5: Review of cardiovascular disease risk factors

Quality statement

People with hypertension are offered a review of risk factors for cardiovascular disease annually.

Rationale

People's blood pressure and cardiovascular disease risk will increase over time. A review of risk factors for cardiovascular disease delivered as part of an annual review of care should support identification of increased risk and provide an opportunity to address modifiable risk factors.

Quality measure

Structure: Evidence of local arrangements to ensure people with hypertension are offered a review of risk factors for cardiovascular disease annually.

Process: Proportion of people who have had hypertension for 12 months or longer who have had a review of risk factors for cardiovascular disease within the past 12 months.

Numerator – the number of people in the denominator who have had a review of risk factors for cardiovascular disease within the past 12 months.

Denominator – the number of people who have had hypertension for 12 months or longer who do not have established cardiovascular disease.

What the quality statement means for each audience

Service providers ensure systems are in place to offer people with hypertension a review of risk factors for cardiovascular disease annually.

Healthcare professionals offer people with hypertension a review of risk factors for cardiovascular disease annually.

Commissioners ensure they commission services that offer people with hypertension a review of risk factors for cardiovascular disease annually.

People with hypertension (high blood pressure) are offered a review of risk factors for cardiovascular disease annually.

Source guidance

NICE clinical guideline 127 recommendation 1.7.3.

Data source

Structure: Local data collection.

Process:

Quality and Outcomes Framework (QOF) indicator CVD-PP02: The percentage of patients diagnosed with hypertension (diagnosed on or after 1 April 2009) who are given lifestyle advice in the preceding 12 months for: smoking cessation, safe alcohol consumption and healthy diet.

Quality and Outcomes Framework (QOF) indicator SMOK005: The percentage of patients with any or any combination of the following conditions: CHD PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 12 months.

Definitions

Annual review of care

NICE clinical guideline 127 recommendation 1.7.3 recommends that an annual review of care should be provided to monitor blood pressure, provide people with support and discuss their lifestyle, symptoms and medication.

Review of risk factors for cardiovascular disease

Review of risk factors for cardiovascular disease could include:

  • smoking status

  • alcohol consumption

  • blood pressure

  • body mass index or other measure of obesity

  • total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides

  • blood glucose

  • renal function

  • liver function (transaminases) if receiving statins

  • heart rate and rhythm (pulse measurement).

(adapted from NICE clinical guideline 67 recommendation 1.4.2)

Blood pressure should be measured more frequently than annually for patients who need more frequent monitoring.