NICE recommends blood pressure device that can help prevent stroke

A new device that allows GPs and practice nurses to detect pulse irregularities and pick up cases of atrial fibrillation whilst measuring blood pressure has been recommended by NICE.

A new device that allows GPs and practice nurses to detect pulse irregularities and pick up cases of atrial fibrillation whilst measuring blood pressure has been recommended by NICE.

Atrial fibrillation (AF) causes the heart to beat with an irregular rhythm. It can be difficult to detect and subsequently diagnose as it is often asymptomatic and can be intermittent.

People with AF are at increased risk of developing blood clots and subsequent stroke, with 423,000 people aged 65 and over expected to have AF, of whom some will be will living with the condition yet are undiagnosed.

In its medical technology guidance on WatchBP Home A, NICE says the device reliably detects AF and may increase the rate of detection when used in primary care. This will consequently allow for preventative treatment to be given and to reduce the incidence of AF-related stroke.

NICE also says the WatchBP Home A device should be considered for use in people with hypertension or those being screened for hypertension in primary care. People with suspected AF should have an electrocardiogram (ECG) in line with current AF guidance from NICE.

NICE estimates that around 74,000 people with AF will be detected nationally, who can then receive treatment if the device is used.

Cost savings are expected to reach £26.7 million per year, once a steady state of use is reached. Savings will mainly be achieved through avoiding stroke and through a reduction in the number of ECGs needed to check false-positive results, which occur when the pulse is taken by hand.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: "We are delighted to publish this new guidance supporting the use of Watch BP Home A for picking up AF whilst blood pressure is being measured in some people.

"The evidence considered by the independent Medical Technologies Advisory Committee (MTAC) indicates that the device can offer advantages in detecting AF opportunistically whilst measuring blood pressure, and that using the device in primary care could increase the detection rate of atrial fibrillation compared with taking the pulse by hand."

She added: "Using WatchBP Home A is associated with estimated overall cost savings per person screened of between £2.98 and £4.26 for people aged 65 or over, depending on their age.

"This guidance will give the NHS confidence in deciding whether to introduce the WatchBP Home A device to help detect atrial fibrillation in specified groups of people who are having their blood pressure taken."

A range of implementation tools have been produced by NICE to help support the use of this guidance.

These include a costing report, implementation advice, and guides for commissioning an anticoagulation therapy service and integrated services for the prevention of cardiovascular disease.

Details of how WatchBP Home A was adopted by one particular GP can also be found in a case study that was submitted to the NICE Shared Learning database in December 2012.

The example includes some of the benefits seen from using the device, as well a summary of results from the first six months of its use.