Hypertension (high blood pressure)

Overview

Burden

No burden claims are published.

Claims and evidence

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

• Claim, not a settled fact WHO 2012: hypertension is a major risk factor for cardiovascular disease, in particular for heart attack and stroke: Stroke (Associated with a higher risk of)

  Applies to Recipient not specified

  • The background passages state no population. They are general statements in a guideline about sodium intake in adults and children, so the claim is not scoped to an age group or to pregnancy.
  • Not stated in the source
  • Not stated in the source
  • Not stated in the source
  • Gestational age Not reported
  • Postnatal age Not reported

  Follow-up Not applicable (background statement)
  The WHO 2012 sodium guideline calls hypertension a major risk factor for cardiovascular disease, in particular for heart attack and stroke. It also says the link between higher blood pressure and higher risk of cardiovascular disease, coronary heart disease and stroke most of all, is well established.

  Limitations. A background statement in a guideline about sodium; the fetched text gives no study data for it and does not say how much hypertension raises stroke risk. The second statement concerns blood pressure as a continuous measure, not the diagnosis of hypertension. It does not say that lowering blood pressure prevents stroke.

• Claim, not a settled fact Recommended for this: Home blood pressure monitoring (Recommended for, seen from the other side)

  Applies to Adult

  • Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.
  • Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)
  • England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.
  • Adult (aged 18 and over)

  Follow-up Not applicable (recommendation context)
  NICE guideline NG136 recommends offering home blood pressure monitoring (HBPM) to confirm a diagnosis of hypertension in adults when ABPM is not suitable or not tolerated.

  Limitations. NICE gives no strength label for this recommendation. Its verb is offer. NICE says it uses that verb where the evidence of benefit is strong and leaves little doubt. How NICE applied that convention here was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The recommendation carries the year tag 2019, the year of NICE's evidence review. No NICE evidence review was read. NICE places this recommendation second, after ABPM. This claim records what NICE recommends. It does not say how well home monitoring performs, and it covers no pregnancy use.

• Claim, not a settled fact Recommended for this: Ambulatory blood pressure monitoring (ABPM) (Recommended for, seen from the other side)

  Applies to Adult

  • Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.
  • Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)
  • England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.
  • Adult (aged 18 and over)

  Follow-up Not applicable (recommendation context)
  NICE guideline NG136 recommends offering ambulatory blood pressure monitoring (ABPM) to confirm a diagnosis of hypertension in adults whose clinic blood pressure is between 140/90 and 180/120 mmHg.

  Limitations. NICE gives no strength label for this recommendation. Its verb is offer. NICE says it uses that verb where the evidence of benefit is strong and leaves little doubt. How NICE applied that convention here was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The recommendation carries the year tag 2019, the year of NICE's evidence review. No NICE evidence review was read. A clinic reading of 180/120 mmHg or higher is handled in a separate NICE referral section. This claim records what NICE recommends. It does not say that ABPM is the only or best way to confirm the diagnosis.

• Claim, not a settled fact Recommended for this: Blood pressure lowering medicine (Recommended for, seen from the other side)

  Applies to Adult

  • 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.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO recommends starting blood-pressure-lowering medicine in adults with confirmed hypertension whose systolic pressure is 140 mmHg or higher or whose diastolic pressure is 90 mmHg or higher.

  Limitations. WHO labels this statement "Strong recommendation, moderate- to high-certainty evidence". The label gives the certainty as a range, which the claim certainty scale cannot hold, so the certainty stays not assessed. An implementation remark says treatment should start no later than four weeks after diagnosis. 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.

• Claim, not a settled fact Recommended for this: Blood pressure lowering medicine (Recommended for, seen from the other side)

  Applies to Adult

  • Adults with existing cardiovascular disease and a systolic blood pressure of 130 to 139 mmHg. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed with hypertension.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO recommends blood-pressure-lowering medicine in adults with existing cardiovascular disease whose systolic pressure is 130 to 139 mmHg.

  Limitations. WHO labels this statement "Strong recommendation, moderate- to high-certainty evidence". The label gives the certainty as a range, which the claim certainty scale cannot hold, so the certainty stays not assessed. This statement sits beside 1a and 1c, which carry other populations and, for 1c, a different strength. 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.

• Claim, not a settled fact Recommended for this: Blood pressure lowering medicine (Recommended for, seen from the other side)

  Applies to Adult

  • Adults without cardiovascular disease who have high cardiovascular risk, diabetes mellitus or chronic kidney disease, and a systolic blood pressure of 130 to 139 mmHg. WHO says the guideline targets non-pregnant adults who were appropriately diagnosed with hypertension.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO suggests blood-pressure-lowering medicine in adults without cardiovascular disease who have high cardiovascular risk, diabetes or chronic kidney disease and whose systolic pressure is 130 to 139 mmHg.

  Limitations. WHO labels this statement "Conditional recommendation, moderate- to high-certainty evidence". It is a suggestion, weaker than 1a and 1b. The label gives the certainty as a range, which the claim certainty scale cannot hold, so the certainty stays not assessed. 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.

• Claim, not a settled fact Recommended for this: Blood pressure lowering medicine (Recommended for, seen from the other side)

  Applies to Adult

  • 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.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO recommends that adults with hypertension who need medicine start with a drug from any of three classes: thiazide and thiazide-like agents, ACE inhibitors or angiotensin-receptor blockers, or long-acting dihydropyridine calcium channel blockers.

  Limitations. WHO labels this statement "Strong recommendation, high-certainty evidence". The certainty above is that label. 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.

• Claim, not a settled fact Recommended for this: Blood pressure lowering medicine (Recommended for, seen from the other side)

  Applies to Adult

  • 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.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO suggests that adults with hypertension who need medicine start with combination therapy, preferably as a single-pill combination, with the drugs chosen from diuretics (thiazide or thiazide-like), ACE inhibitors or angiotensin-receptor blockers, and long-acting dihydropyridine calcium channel blockers.

  Limitations. WHO labels this statement "Conditional recommendation, moderate-certainty evidence". The certainty above is that label. It sits beside recommendation 4, which allows a start with a single drug from any of the classes; the page shows both. 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.

• Claim, not a settled fact Recommended for this: Blood-pressure lowering to a target (Recommended for, seen from the other side)

  Applies to Adult

  • Adults with hypertension aged under 80, with or without type 2 diabetes (NG136 Table 1)
  • Not stated on the fetched page
  • Not stated on the fetched page (NICE guidance; jurisdiction not verified)
  • Adult under 80

  Follow-up Not applicable (recommendation context)
  NICE guideline NG136 recommends lowering clinic blood pressure below 140/90 mmHg, and keeping it there, for adults with hypertension aged under 80.

  Limitations. NICE's population includes people with type 2 diabetes, whom SPRINT excluded. The fetched page gives no strength label for this imperative wording (a pair of directive verbs, one to lower the pressure and one to keep it there), and NICE's page on recommendation wording explains only the verbs offer and consider. The jurisdiction is not stated on the fetched page. The recommendation carries the tag 2019, amended 2022; the exact amendment date was not recorded. This claim records what NICE recommends. It does not say that NICE assessed or rejected SPRINT's target.

• Claim, not a settled fact Recommended for this: Blood-pressure lowering to a target (Recommended for, seen from the other side)

  Applies to Adult

  • Adults with hypertension and no comorbidities. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: "In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. WHO says the guideline targets non-pregnant adults.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO recommends a blood pressure target of below 140/90 mmHg for adults with hypertension who have no comorbidities.

  Limitations. WHO labels this statement "Strong recommendation, moderate-certainty evidence". The certainty above is that label. The recommendation statement does not define comorbidities. The rationale on the same page (PDF page 28) names them: "In patients with comorbidity (CAD, DM, CKD) there is consistent benefit with lower targets", where WHO's list of acronyms gives CAD as coronary artery disease, DM as diabetes mellitus and CKD as chronic kidney disease. Statements 6b and 6c set a lower systolic target for two other groups. NICE sets its own target in a separate claim. 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.

• Claim, not a settled fact Recommended for this: Blood-pressure lowering to a target (Recommended for, seen from the other side)

  Applies to Adult

  • Adults with hypertension and known cardiovascular disease. WHO says the guideline targets non-pregnant adults.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO recommends a systolic blood pressure target of below 130 mmHg for adults with hypertension and known cardiovascular disease.

  Limitations. WHO labels this statement "Strong recommendation, moderate-certainty evidence". The certainty above is that label. 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.

• Claim, not a settled fact Recommended for this: Blood-pressure lowering to a target (Recommended for, seen from the other side)

  Applies to Adult

  • Adults with hypertension who are at high risk, which WHO lists as high cardiovascular risk, diabetes mellitus or chronic kidney disease. WHO says the guideline targets non-pregnant adults.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • Adult

  Follow-up Not applicable (recommendation context)
  WHO suggests a systolic blood pressure target of below 130 mmHg for adults with hypertension who are at high risk because of high cardiovascular risk, diabetes or chronic kidney disease.

  Limitations. WHO labels this statement "Conditional recommendation, moderate-certainty evidence". It is a suggestion, weaker than 6a and 6b. The certainty above is that label. 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.

• Claim, not a settled fact Evaluated for this: Intensive systolic blood-pressure lowering (target below 120 mm Hg) (Evaluated for, seen from the other side)

  Applies to Adult

  • Adults aged 50 years or older with systolic blood pressure of 130 to 180 mm Hg (the registry lowers the upper limit as the number of blood-pressure medicines rises) and at least one increased-risk criterion, excluding diabetes mellitus and prior stroke.
  • Outpatient trial clinics at 102 clinical sites. Nursing-home and assisted-living residents were not enrolled.
  • United States, including Puerto Rico
  • Adult, 50 years and over (28.2% of each arm aged 75 or over, per Table 1 of the paper)

  Follow-up Median follow-up 3.26 years when the blood-pressure intervention was stopped early on 2015-08-20. The registry gives a planned maximum follow-up of 6 years. Mean systolic pressure at 1 year was 121.4 mm Hg (intensive) and 136.2 mm Hg (standard).
  In SPRINT, adults aged 50 and over at raised heart risk, without diabetes or a past stroke, whose treatment aimed for a top (systolic) blood pressure below 120 mm Hg had fewer major heart and blood-vessel events than those aiming for below 140. Over a median of 3.26 years, 243 of 4678 people in the lower-target group and 319 of 4683 in the standard group had a first primary-outcome event (hazard ratio 0.75, 95% CI 0.64 to 0.89).

  Source problem. A cited source is corrected. Check the sources before relying on this claim.

  Limitations. One open-label trial; outcome adjudicators did not know the assignment. The blood-pressure intervention was stopped early for benefit after crossing a monitoring boundary. The authors say the results do not generalize to people with diabetes, prior stroke or age under 50, or to nursing-home residents. The paper and the registry word the older-age entry criterion differently ("75 years or older" versus "greater than 75 years"), and this is not reconciled. The publication has a 2017 erratum whose content was not verified. Full-text figures come from the PMC author manuscript.

• Claim, not a settled fact Recommended for this: Hypertension treatment by nonphysician professionals, such as pharmacists and nurses (Recommended for, seen from the other side)

  Applies to Adult

  • 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.
  • Not stated for this recommendation in the source
  • Global WHO guidance; national adoption not recorded
  • 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.

  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.

• Claim, not a settled fact Recommended against for this: Salt substitution (lower-sodium, potassium-containing salt) (Recommended against for, seen from the other side)

  Applies to Adult

  • Adults with suspected or diagnosed hypertension in the groups NICE names for potassium chloride salt substitutes: older people (NICE gives no age), people with diabetes, people with kidney disease, and people on some blood-pressure medicines (for example ACE inhibitors and angiotensin II receptor blockers). The recommendation says people and sits in the lifestyle section addressed to people with suspected or diagnosed hypertension. NICE also names pregnant women; that group is outside this context and belongs to the maternal atlas.
  • Not stated on the fetched page
  • England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.
  • Adult; older people are named but NICE gives no age bound

  Follow-up Not applicable (recommendation context)
  NICE guideline NG136 advises encouraging people to keep their sodium intake low, either by cutting back on salt or by using a salt substitute in its place. It adds that older people, people with diabetes, people with kidney disease, and people on some blood-pressure medicines (for example ACE inhibitors and angiotensin II receptor blockers) should not use salt substitutes that contain potassium chloride, and says these groups should be encouraged to cut down on salt instead. The recommendation is tagged as dating from 2004 and amended in 2019, so it predates the SSaSS report and the WHO salt-substitute guideline, which are recorded separately. NICE also names pregnant women in this list; that group is outside this claim context and belongs to the maternal atlas.

  Limitations. The fetched page gives no reasoning for the caution, and the NICE rationale was not read. It says people, and sits in the lifestyle section whose first recommendation is addressed to people who may have hypertension or have been diagnosed with it. Older people has no age bound. What the 2019 amendment changed was not checked. The wording is imperative with no NICE strength label, and its meaning was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The page shows a last update of 26 February 2026. NICE's reuse terms limit outside use of its wording, so this atlas states the caution in its own words. This caution and the WHO suggestion are shown side by side; neither is shown to be right.

Record details

Record id

core:hypertension

Content hash

22bc57139b1a3f13eee544b4a3e5e687807d2548663eef9adef01de1bc242aac