Quality standard

Quality statement 5: Review of cardiovascular disease risk factors

Quality statement 5: Review of cardiovascular disease risk factors

Quality statement

Adults with hypertension have an annual review of risk factors for cardiovascular disease.

Rationale

Adult's blood pressure and cardiovascular disease risk increases over time. A review of risk factors for cardiovascular disease delivered as part of an annual review of care should support identification of increased risk and provide an opportunity to address modifiable risk factors.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of adults who have had hypertension for 12 months or longer who have had a review of risk factors for cardiovascular disease within the past 12 months.

Numerator – the number of adults in the denominator who have had a review of risk factors for cardiovascular disease within the past 12 months.

Denominator – the number of adults who have had hypertension for 12 months or longer who do not have established cardiovascular disease.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records. CVD Prevent indicator CVD004HYP reports the percentage of patients aged 18 and over with GP-recorded hypertension who have had a blood pressure reading within the preceding 12 months. CVD Prevent indicator CVDP001SMOK reports the percentage of patients aged 18 and over with GP-recorded cardiovascular disease or risk factors (including hypertension) who are GP-recorded current smokers or have no smoking status recorded, whose notes record smoking status in the preceding 12 months. Quality and Outcomes Framework indicator SMOK002 reports the percentage of patients with hypertension whose notes record smoking status in the preceding 12 months. Quality and Outcomes Framework indicators no longer in QOF (INLIQ) indicator CVD-PP02 reports the percentage of patients diagnosed with hypertension (on or after 1 April 2009) who are given lifestyle advice in the preceding 12 months for smoking cessation, safe alcohol consumption and healthy diet.

What the quality statement means for different audiences

Service providers (such as general practices) ensure that systems are in place to offer adults with hypertension an annual review of risk factors for cardiovascular disease.

Healthcare professionals (such as GPs and practice nurses) offer adults with hypertension an annual review of risk factors for cardiovascular disease.

Commissioners ensure that they commission services that offer adults with hypertension an annual review of risk factors for cardiovascular disease.

Adults with hypertension (high blood pressure) are offered a review of risk factors for cardiovascular disease each year.

Source guidance

Hypertension in adults: diagnosis and management. NICE guideline NG136 (2019, updated 2023), recommendation 1.4.24

Definitions of terms used in this quality statement

Annual review

An annual review to monitor blood pressure, provide adults with support and discuss their lifestyle, symptoms and medication. [NICE's guideline on hypertension in adults, recommendation 1.4.24]

Review of risk factors for cardiovascular disease

Review of risk factors for cardiovascular disease could include:

  • smoking status

  • alcohol consumption

  • blood pressure

  • body mass index or other measure of obesity

  • full lipid profile

  • diabetes status

  • renal function

  • transaminase level (alanine aminotransferase or aspartate aminotransferase)

  • thyroid-stimulating hormone in people with symptoms of underactive or overactive thyroid.

[Adapted from NICE's guideline on cardiovascular disease: risk assessment and reduction, including lipid modification, recommendation 1.5.5]