The National Institute for Health and Clinical Excellence (NICE) has today announced that it is to work with the British Hypertension Society (BHS) in a preliminary review of new data on the management of hypertension. The decision to set up an Expert Advisory Group to advise on the impact of the new data on the current NICE and BHS hypertension guidelines, anticipates the forthcoming publication of the results of the Anglo Scandinavian Cardiac Outcome Trial (ASCOT) which evaluated combinations of modern anti-hypertensive drugs compared with older regimes.

Professor Peter Littlejohns, NICE Clinical and Public Health Director, commented: "NICE guidelines are not usually considered for updating until four years after publication. However in this case, because a potentially significant piece of new evidence is about to be published, NICE feels it is appropriate to look at this data in the context of our existing recommendations to see whether any revision might be necessary."

He continued: "Because the ASCOT study is likely also to have implications for the BHS's own guideline on the management of hypertension, it was felt that a collaborative approach will avoid unnecessary duplication of effort and also reduce the potential for confusion for both healthcare professionals and patients."

Professor Bryan Williams, a member of the Guideline Development Group which developed the original NICE guideline and Chairman of the British Hypertension Society's NHS Guideline Development Group, added: "Early indications from the ASCOT study suggest that the results have the potential to change the pharmacological treatment algorithms in the current NICE and BHS guidelines, and the recommendations underpinning these algorithms. Today's announcement therefore represents a very important step in moving towards the provision of clear guidance to the NHS, from a single source, that will have the potential to influence and improve the treatment of a significant proportion of the adult population of the UK. "

About NICE

1 On 1 April 2005 the National Institute for Clinical Excellence took on the functions of the Health Development Agency to form the National Institute for Health and Clinical Excellence (NICE). NICE is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
2 NICE produces guidance in three areas of health:
• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

About the BHS

1 The BHS provides a medical and scientific research forum to enable sharing of cutting edge research in order to understand the origin of high blood pressure and improve its treatment.
2 The BHS has a track record of producing internationally renowned guidelines for the management of hypertension which are widely adopted in primary care in the UK and elsewhere.
3 The BHS has also established an educational programme to support scientists, doctors and other healthcare workers involved in understanding the basis of high blood pressure and improving its treatment throughout the UK.

The process for updating the guideline

1 Initially an Expert Advisory Group, chaired by Professor Bryan Williams and comprising representatives from NICE, the BHS, the Blood Pressure Association, patient/carer groups and the chair of the NICE Hypertension guideline development group which developed the existing NICE guideline, will consider the results of the ASCOT study and advise the Centre for Clinical Practice at NICE on the need to update the NICE guideline in the light of these results.
2 If, following the advice of the Expert Advisory Group, NICE decides that its guideline needs to be updated, it will arrange for a National Collaborating Centre (NCC) to carry out this work.
3 The NCC would be asked to synthesise the results of the ASCOT study with other relevant evidence, undertake economic analysis and present this to a Guideline Development Group (GDG) who will then develop the guideline recommendations based on this.
4 The composition of the GDG will include representatives of the healthcare professions and patient/carer groups.
5 Validation of the guideline will include a period of stakeholder consultation. 6 The final guideline will be endorsed by the BHS and will replace their current guideline in this area.

British Hypertension Society