Blood pressure test changes expected to cut misdiagnoses

Roll-out of scheme that monitors patients for 24 hours could cut hypertension rates and save the NHS £10m a year More than a quarter of patients may have been misdiagnosed for high blood pressure, a finding that will see the way doctors identify hypertension changed for the first time in more than a century. Guidelines published on Wednesday by the National Institute for Health and Clinical Excellence (Nice) recommend that patients should be monitored for 24 hours to determine whether they have high blood pressure rather than having a measurement taken in a doctor’s surgery. The 24-hour process, ambulatory blood pressure monitoring (ABPM), involves wearing a cuff and a box on a belt for a day. The patient then brings it back the following day for the recording to be downloaded on to a computer and an automatic report generated. Currently patients have a number of appointments to have their blood pressure checked, and it is estimated that 25% suffer from “white-coat hypertension” – a syndrome in which people show elevated blood pressure in a surgery or hospital but nowhere else. Bryan Williams, professor of medicine at the University of Leicester, who chaired the Nice hypertension guideline committee, said any patients who had been misdiagnosed would be identified as the system was adopted across the NHS. He said: “Everybody on treatment is under periodic, usually annual, review and that is the opportunity to consider whether or not the original diagnosis was the right one.” He added that 10% of the NHS could introduce “this tomorrow … Our modelling showed that for every 100,000 people this new method would cost £2.5m in the first year. But by year five you would see savings of £10m a year.” The guideline panel expect that the new process will take about a year to introduce and that the cost of the machines, currently around £1,000 each, could halve. The new advice also recommends that people over 80 are treated for high blood pressure. In the past there has been debate over whether this will cause more harm than good. But Williams said that patients would benefit. In the UK 12 million people have high blood pressure and almost half are undiagnosed. It is estimated that the condition costs the NHS £1bn a year in drugs alone. Managing high blood pressure is the most important thing patients can do to lessen their risk of a stroke – the third most lethal condition after cancer and heart disease and leading cause of severe disability. It is estimated that 20% of hospital beds are occupied by stroke victims. Cathy Ross, senior cardiac nurse at the British Heart Foundation, said: “The number of people with high blood pressure in the UK is staggering. It’s a major risk factor for heart disease and strokes so it’s crucial we do all we can to get people diagnosed and properly treated as soon as possible.” Although there is no debate over the existence of white coat syndrome, some researchers argue that even mild exercise can influence readings and patients should be at home when an assessment is made. A study in Finland five years ago concluded that the home approach “is more convenient and better accepted by the patients for long-term use and also less costly compared to ambulatory monitoring.” However, a study accompanying the Nice guidelines found that ambulatory monitoring was the most cost-effective way to diagnose hypertension among men and women of all ages. For women aged 40, the saving was £323 for each patient. The health minister Anne Milton said: “Hypertension is a serious public health issue that affects up to a third of the population and needs to be better managed in primary care. “Getting the diagnosis right is vital in order to make sure that all patients who need treatment get it before they go on to develop a more serious condition.” NHS Health Randeep Ramesh guardian.co.uk

Posted by on August 24, 2011. Filed under News, Politics, World News. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.