NICE classification1
NICE targets1,2
NICE NG136 and NG203 recommend reducing and maintaining BP to the targets below depending on the person’s age and profile. Targets are the same for people with and without cardiovascular disease. There is insufficient evidence to support lower blood pressure targets for people with diabetes, other than in those with coexisting CKD.
KDIGO recommendations for people with chronic kidney disease3
● Adults with high BP and CKD should be treated to a target SBP of <120 mmHg (also applies to the subgroups of older adults and those with increased albuminuria).
● The balance of benefits and harms is less certain in people with CKD G5 and in those with severely increased albuminuria (A3).
● The benefits of intensive BP lowering are less certain among patients with concomitant CKD and diabetes, compared to patients with CKD without diabetes.
2023/2024 QOF blood pressure indicators
● Diabetes (excluding moderate or severe frailty: ≤140/90 mmHg
● Coronary heart disease/hypertension/stroke/TIA:
- Age <80 years: ≤140/90 mmHg
- Age ≥80 years: ≤150/90 mmHg
● There is no QOF BP target for those with CKD.
Early data from the NHS Type 2 Diabetes Path to Remission programme show it is effective in achieving remission at scale outside of clinical trials.
3 Sep 2024