Editor—Williams et al in their summary of the British Hypertension Society's guidelines say that people with “high normal” systolic blood pressure (130-139 mm Hg) or diastolic blood pressure (85-89 mm Hg) and people who have had high blood pressure readings at any time previously should have their blood pressure measured annually.1 This implies that any patient who has ever had a systolic blood pressure greater than 130 mm Hg should from then on be kept under annual review.
A search of our general practice database of 6200 patients showed that 1700 fell into this category. A check of similar practices shows that this figure is reasonably representative in our area. Our practice population is below average in age and deprivation. Some simple mathematics suggests that as a practice we need to review 34 patients a week.
Can I ask the authors what consideration was given to the practical implications of their guidelines? Did they look at how this guideline might be implemented? Have they looked at the effect it might have on already overspent prescribing budgets? What effect will this have on practice workload?
The figures above suggest this guideline is unworkable in the real world of general practice.
See editorial by Campbell
Competing interests: None declared.
References
- 1.Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary. BMJ 2004;328: 634-40. (13 March.) [DOI] [PMC free article] [PubMed] [Google Scholar]