British Hypertension Society guidelines (BHS-IV)
The Journal of Family Practice. 2004 July;53(7):522-530
July 1, 2004|Family Medicine
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- CLINICAL QUESTION: How should hypertension be managed?
- STUDY DESIGN: Practice guideline
- SETTING: Various (guideline)
- SYNOPSIS: The British Hypertension Society has issued their fourth update on the treatment of hypertension (BHS-IV). The guidelines give a strength of recommendation on the basis of the quality of evidence, ranging from A (directly based on a meta-analysis of controlled trials) to D (expert recommendation or extrapolation from other data).
BOTTOM LINE
The British Hypertension Society guidelines (BHS-IV) and the American Joint National Committee guidelines (JNC-7) are very similar in treatment goals. However, the BHS-IV guidelines do not require treatment until both the systolic and diastolic numbers are greater than 160/100 mm Hg, respectively, for patients without cardiovascular disease, diabetes, or other organ damage, whereas the JNC-7 guidelines start drug treatment in all patients with both numbers greater than 140/90 mm Hg. The BHS-IV suggests initial treatment with any 1 of 4 drugs (see the ABCD rule in the synopsis), whereas the bedrock of treatment recommended by the JNC-7 is diuretics, primarily because of the lower cost. (LOE=5)
