Textbook response to ACE inhibitors

NICE guidelines for treating hypertension

Hypertension was identified by the GP and Ramipril 2.5mg was prescribed. The patient was not particularly bothered and could not remember his BP. We offered a before-and-after CV screen to help the patient understand his condition, offer some lifestyle advice and confirm how to take the Ramipril.

The patient was asked to return after 7 days for a follow-up screen. (For the NMS case we only perform the CV section of the health-check. The patient was asked to bring a copy of his blood test results along when it is available to complete the questionnaire.)


NICE guidelines for treating hypertension

After 7 days on Ramipril 2.5mg as well as an altered exercise regime, both peripheral and central blood pressures improved as per images. The augmentation index and pulse curve improved as well.

The results were discussed with the patient and he is now fully empowered to look after his CV health. He was very keen to make the 14 days NMS appointment for a follow-up and understood that after that he will have to pay for follow-up screens. He was quite happy to pay for a follow-up CV screen as he is keen to follow the effect of his exercise regime on his pulse wave analysis.


From a more or less non-bothered patient, we now have a fully committed, engaged and adherent patient.