700,000 more given blood pressure pills to beat heart attacks

HUNDREDS of thousands more people are to be offered blood pressure drugs to cut the toll of heart attacks and strokes.

The threshold at which the drugs can be prescribed is to be lowered, a draft plan published today by the NHS watchdog NICE reveals.

The move is the biggest change to blood pressure guidance in nearly a decade, and will make an additional 720,000 people eligible for daily pills.

The proposal, which is under consultation until a decision is made in August, would more than triple the number offered medication for stage-one blood pressure, pushing those eligible up from 290,000 to more than 1million.

NICE said the move was vital to reduce the toll of 75,000 killed by high blood pressure in Britain each year.

But last night’s announcement split medical experts, raising concerns that it would lead to over-diagnosis.

Leading GPs warned that people would be given drugs they did not need,

‘It is wishful thinking’

and should instead be advised to eat more healthily and take more exercise.

Cardiologists, however, said the threshold had not been lowered enough and would leave millions of people at risk.

Anthony Wierzbicki, chairman of the NICE guideline committee, said: ‘A rigorous evaluation of new evidence has resulted in updated recommendations around when to treat raised blood pressure that have the potential to make a real difference to the lives of many thousands of people with the condition.

‘This would keep people well for longer and reduce the long-term need for multiple medications.’

Blood pressure is expressed as two readings – a systolic one representing the pressure as your heart pushes blood out, and a diastolic reading of the pressure as your heart rests between beats.

A healthy level is considered to be between 90/60 and 120/80.

Hypertension – the medical term for high blood pressure – applies to anyone with a systolic score of more than 140 or a diastolic number of more than 90.

The guidance relates to people with stage-one hypertension – those with a reading between 140/90 and 160/100.

Previously, people in this group would only be eligible for pills if they were also judged to have a 20 per cent chance of developing heart disease in the next decade.

The new guidance lowers this threshold to those with a 10 per cent risk, which adds an extra 450,000 men and 270,000 women.

In addition, millions more severe cases – those with stages 2 and 3 forms of high blood pressure – will continue to be advised to take the inexpensive drugs.

Experts say that in total 13.5million people in England have high blood pressure, and 8million are eligible to take the drugs.

But they stress that most do not take the pills, either because they have not been diagnosed with blood pressure problems or they simply refuse medication.

Professor Francesco Cappuccio, president of the British and Irish Hypertension Society, said the guidance was ‘conservative’ compared with guidelines in the US and Europe, which lower the threshold for medication much further. But he added: ‘Implementation of the guidance is abysmal, so the numbers are not that important. The guidance is a step forward but it is wishful thinking.

‘It would have been better if NICE had been more ambitious.’

However, Professor Helen Stokes-Lampard, chairman of the Royal College of GPs, said: ‘Many GPs have concerns about overdiagnosis and the unintended harms of prescribing medication when benefits may be limited.

‘Lowering the threshold for making a diagnosis of high blood pressure is likely to affect thousands, if not millions of patients.’