Drug treatment for high blood pressure is set to undergo a major shake-up after new guidance was issued for the NHS.
Family doctors in the UK are being advised not to prescribe beta-blockers as the routine “first-line” therapy for high blood pressure in favour of other treatments.
New guidelines issued by the National Health Service (NHS) follows advice from the National Institute for Health and Clinical Excellence (NICE) which says other drugs are better at treating hypertension.
These include calcium channel blockers, diuretics and ACE (Angiotensin-converting Enzyme) inhibitors, used to regulate the hormonal system and open up blood vessels.
The new guidelines come from research which has found that the newer drugs used to treat high blood pressure cut the risk of heart attacks and strokes by half when compared to older treatments.
High blood pressure, or hypertension, is a major cause of preventable death and disability and it is estimated that around 40% of adults in England and Wales suffer from the condition.
In 2001, the NHS funded 90 million prescriptions for drugs which lower blood pressure.
As many as two million people take beta-blockers in the UK, although some take the drugs for conditions such as angina and anxiety and will be unaffected by the guidance.
The guidance was developed in conjunction with the British Hypertension Society, and updates NICE guidance on drugs for managing hypertension issued in 2004.
To simplify the recommendations say that:-
- For patients under 55, the first choice should be an ACE inhibitor, followed by a calcium channel blocker or a diuretic, then all three.
- For patients over 55, or black patients, first choice should be a calcium channel blocker or diuretic, followed by an ACE inhibitor, and then all three if necessary.
- Beta-blockers should no longer be used for hypertension except in patients who need them for other reasons such as heart failure
- Patients under the age of 55 years should start treatment with an ACE inhibitor.
Patients are advised to continue taking their medication and discuss with their doctor the appropriate treatment for them.
Revision date: June 21, 2011
Last revised: by Sebastian Scheller, MD, ScD