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Need to know: Making sense of blood pressure readings in people with diabetes

Jane Diggle
A printable guide to blood pressure classification and targets in diabetes.

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.

REFERENCES:

1. NICE (2023) Hypertension in adults: diagnosis and management [NG136]. Available at: https://www.nice.org.uk/guidance/ng136

2. NICE (2021) Chronic kidney disease: assessment and management [NG203]. Available at: https://www.nice.org.uk/guidance/ng203

3. KDIGO Blood Pressure Work Group (2021) KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int 99(Suppl 3): S1–8

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