Diagnosis and management of hypertension in adults: NICE guideline update 2019

In Aug 2019, the National Institute for Health and Care Excellence (NICE) released its new hypertension guidelines. As previously, it is recommended that diagnosis is based on out-of-office measurement, given the risk of white-coat hypertension, defined as a difference of >20/10 mmHg between clinic readings and average daytime home or ambulatory measurements. The gold standard is ambulatory BP monitoring (ABPM) but, as this is not suitable or tolerated by everyone, home BP monitoring (HBPM) is offered as an alternative. The diagnostic threshold for ABPM or HBPM remains 135/85 mmHg. Standing BP should be measured in those with type 2 diabetes, aged ≥80 years, and patients with symptoms of postural hypotension.