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The British Hypertension Society (BHS) has recently published its latest guidance for the management of hypertension, BHS-IV. This article summarises these recommendations and discusses the main features of the new guidance.
The British Hypertension Society (BHS) has recently published its latest guidance for the management of hypertension, BHS-IV. Two versions have been published: a full detailed document and a shorter executive summary document. The longer version is comprehensive and contains a full description of the rationale for the various recommendations. It also contains succinct sections providing practical advice on the management of hypertension and cardiovascular risk in various patient populations, including: the elderly and the young, women, pregnancy and different ethnic groups. In addition, there are sections detailing clinical management of hypertension and cardiovascular risk in people with cerebrovascular disease and those with diabetes and/or chronic renal disease. The full document also discusses implementation, audit and the implications of the General Medical Services contract. The shorter version highlights the main recommendations for hypertension and cardiovascular risk management by lifestyle changes and drug therapy.
The guideline development process was overseen by the BHS guidelines working party (appendix 1) and the document was available for review at two draft stages by members of the BHS and a number of national stakeholders (appendix 2). This review process was invaluable and ensured that the final document represented the input from various professional agencies, and patients. The new guideline builds on the work of the previous BHS guideline published nearly five years ago. This update was considered necessary because of the wealth of new data on lifestyle measures and drug therapies, and to reinforce the emphasis on the need to improve blood pressure (BP) control and cardiovascular risk management. With regard to these two objectives, the new guideline contains: i) specific recommendations on logical combinations of BP lowering drug therapy using the AB/CD algorithm, and ii) the new Joint British Societies cardiovascular risk chart to guide risk assessment and treatment.
A summary of the recommendations is given below. This is followed by a discussion of the main features of the new guidance.
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