# Hypertension treatment by nonphysician professionals, such as pharmacists and nurses Intervention · id `cardio:nonphysician-hypertension-treatment` · Cardiovascular Atlas · release `2b2017b84496b985` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Nonphysician hypertension treatment Browse, condition area: High blood pressure ## In plain language Health professionals who are not doctors, such as pharmacists and nurses, providing blood pressure medicine, as long as they have proper training and prescribing authority, follow set management protocols and work under a doctor's oversight. ## Technical summary WHO 2021 recommendation 8 (conditional, low-certainty evidence) suggests that nonphysician professionals such as pharmacists and nurses can provide pharmacological treatment of hypertension when proper training, prescribing authority, specific management protocols and physician oversight are in place. Which professionals may prescribe in a given country was not checked. ## Claims, with the population each applies to ## Context: Adults with confirmed hypertension (WHO 2021 recommendations 1a, 4, 5 and 8) Recipient: Adult; Population: Adults with a confirmed diagnosis of hypertension. Recommendation 1a covers systolic 140 mmHg or higher or diastolic 90 mmHg or higher. Recommendations 4, 5 and 8 cover adults with hypertension who need medicine. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed and counselled about lifestyle changes.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) ### WHO suggests that medicine for hypertension can be provided by nonphysician professionals such as pharmacists and nurses, provided there is proper training, prescribing authority, specific management protocols and physician oversight. - Category: Recommendation - Evidence stage: Guidance - Certainty: Low certainty (method: The certainty is the GRADE level WHO prints in the strength label of this recommendation. It is WHO's assessment of the evidence base, not an assessment by this atlas.) - Applies to: Recipient: Adult; Population: Adults with a confirmed diagnosis of hypertension. Recommendation 1a covers systolic 140 mmHg or higher or diastolic 90 mmHg or higher. Recommendations 4, 5 and 8 cover adults with hypertension who need medicine. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed and counselled about lifestyle changes.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Limitations: WHO labels this statement "Conditional recommendation, low-certainty evidence". The certainty above is that label. The conditions are part of the recommendation, and none of them was checked against any country's rules. Global WHO guidance written for adults who are not pregnant; national adoption is not recorded. No evidence review behind the recommendation was read by this cluster. The WHO publication page and the PDF disagree on the page count (48 versus 61); this was not resolved. - Last checked: 2026-10-11 - Sources: 1. Supports: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 31, section 3.8, recommendation 8, statement (part 1). Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: Who may provide treatment. 2. Supports: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 31, section 3.8, recommendation 8, statement (part 2). Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The conditions that must be met. 3. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 31, section 3.8, recommendation 8, strength label. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: The strength label WHO prints under the statement: Conditional recommendation, low-certainty evidence 4. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 2, sentence 2. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO scope: adult, non-pregnant patients appropriately diagnosed with hypertension and counselled about lifestyle. 5. Background: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021) (Guideline, edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.) Locator: PDF page 9, Executive summary, paragraph 4, sentence 4. Retrieved 2026-10-11T19:11:40Z. Source state: Current. Snapshot hash: 57f6376d5c9bc4ea6c44873625547c8a5443d5a6ad8c8c422733681563db05fb. How it applies: WHO says it built summary of findings tables with the GRADE approach. ## Guidance, authorization and access ### Recommendation `cardio:rec-who-2021-r8` - Intervention: Hypertension treatment by nonphysician professionals, such as pharmacists and nurses (`cardio:nonphysician-hypertension-treatment`) - Direction: Recommended - Issued by: World Health Organization (`cardio:who`) - Guideline: Guideline for the pharmacological treatment of hypertension in adults (World Health Organization, 2021), edition Two snapshots of one edition, fetched on 2026-10-11: the WHO publication page, and the English PDF through the IRIS REST bitstream (843539 bytes, 61 pages counted from the file). The publication page states 48 pages. This cluster did not resolve the difference. A separate WHO summary edition exists and was not fetched.; snapshot `cardio:who-9789240033986-eng-pdf-2026-10-11` - Jurisdiction: Global WHO guidance; national adoption not recorded - Strength: Conditional recommendation, low-certainty evidence (GRADE. Section 2.5 of the WHO guideline (PDF page 17) says the guideline development group rated the certainty of evidence and developed the recommendations with the GRADE approach, and it defines a strong recommendation and a weak or conditional one.) - Effective: 2021-08-24 (The publication date on the WHO publication page.) - Supersession: Not checked - Applies to: Recipient: Adult; Population: Adults with a confirmed diagnosis of hypertension. Recommendation 1a covers systolic 140 mmHg or higher or diastolic 90 mmHg or higher. Recommendations 4, 5 and 8 cover adults with hypertension who need medicine. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed and counselled about lifestyle changes.; Care setting: Not stated for this recommendation in the source; Geography: Global WHO guidance; national adoption not recorded; Life stage: Adult; Follow-up: Not applicable (recommendation context) - Basis: claim `cardio:claim-who-2021-r8` ## Connected pages - WHO 2021 8: with training, prescribing authority, protocols and physician oversight (conditional): Hypertension (high blood pressure) (`core:hypertension`) [a claim, not a settled fact; see claim `cardio:claim-who-2021-r8` and its context] - The service delivers the medicines: Blood pressure lowering medicine (`cardio:bp-lowering-medicine`) ## Provenance Content hash: 0f694582bcb2a284948c6b3c5cc3784105c5cf64de19082cb7e0b47258137243 Last substantive edit: 2026-10-11 Evidence last checked: 2026-10-11