QOF

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BP codes

BP Exception code (Added in the last 12 months)

8I3Y. Blood pressure procedure refused

Maximum BP therapy (Added in last 12 months)

8BL0. Patient on maximal tolerated antihypertensive therapy

BP Codes (Added in last 12 months)

The latest Systolic <=150 and Diastolic <=90

246% O/E - blood pressure reading,

Excluding:

2460 O/E - BP unrecordable (v7)
2468. O/E - BP reading:postural drop
246H. O/E - Arterial pressure index normal
246I. O/E - Arterial pressure index abnormal
246K. Target systolic blood pressure
246L. Target diastolic blood pressure
246M. White coat hypertension
246h. Arterial pulse pressure
246i. Diastolic blood pressure centile
246j. Systolic blood pressure centile
246k. Unequal blood pressure in arms

In detail:

246. O/E - blood pressure reading
2461. O/E - BP reading very low
2462. O/E - BP reading low
2463. O/E - BP borderline low
2464. O/E - BP reading normal
2465. O/E - BP borderline raised
2466. O/E - BP reading raised
2467. O/E - BP reading very high
2469. O/E - Systolic BP reading
246A. O/E - Diastolic BP reading
246B. O/E - BP stable
246C. Lying blood pressure reading
246D. Standing blood pressure reading
246E. Sitting blood pressure reading
246F. O/E - blood pressure decreased
246G. O/E - BP labile
246J. O/E - BP reading: no postural drop
246N. Standing systolic blood pressure
246P. Standing diastolic blood pressure
246Q. Sitting systolic blood pressure
246R. Sitting diastolic blood pressure
246S. Lying systolic blood pressure
246T. Lying diastolic blood pressure
246V. Average 24 hour diastolic blood pressure
246W. Average 24 hour systolic blood pressure
246X. Average day interval diastolic blood pressure
246Y. Average day interval systolic blood pressure
246Z. O/E-blood pressure reading NOS
246a. Average night interval diastolic blood pressure
246b. Average night interval systolic blood pressure
246c. Average home diastolic blood pressure
246d. Average home systolic blood pressure
246e. Ambulatory systolic blood pressure
246f. Ambulatory diastolic blood pressure
246g. Self measured blood pressure reading
246l. Average systolic blood pressure
246m. Average diastolic blood pressure
246n. Baseline blood pressure (v30)

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CHD 002.1 Rationale

This indicator measures the intermediate health outcome of a blood pressure of 150/90 mmHg or less in patients with hypertension and CHD. Its intent is to promote the secondary prevention of cardiovascular disease (CVD) through satisfactory blood pressure control. This intermediate outcome can be achieved through lifestyle advice and the use of drug therapy.

The NICE clinical guideline on Hypertension (2011) sets blood pressure thresholds for the initiation of drug treatment of hypertension and these are outlined in the rationale for the hypertension domain. To summarise, patients with CHD and stage one hypertension are recommended drug therapy for hypertension.

The NICE clinical guideline on Hypertension (2011) recommends a target clinic blood pressure below 140/90 mmHg in patients aged 79 or under with treated hypertension and a clinic blood pressure below 150/90 mmHg in patients aged 80 years and over, with treated hypertension.

For the purpose of QOF, an audit standard of 150/90 has been adopted for this indicator.

A major overview of randomised trials showed that a reduction of 5 - 6 mmHg in blood pressure sustained over five years reduces coronary events by 20 - 25 per cent in patients with CHD.

Further information NICE clinical guideline CG127. Hypertension (2011). http://guidance.nice.org.uk/CG127

Collins et al. Lancet 1990; 335: 827-38

CHD 002.2 Reporting and verification

See indicator wording for requirement criteria.

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Prepared By Jean Keenan