Hypertension (HYP) - QOF indicator

Hypertension indicators for 2026/27

The hypertension area of QOF assesses blood pressure control using age-specific targets, with equivalent home readings accepted. For 2026/27, HYP010 and HYP011 replace HYP008 and HYP009 respectively; both exclude patients with moderate or severe frailty to support individually tailored management.

Ongoing management

HYP010: based on NICE IND239

Rationale

• For patients with hypertension aged 79 years or under who do not have moderate or severe frailty, HYP010 uses a blood pressure of 140/90 mmHg or less as an intermediate outcome. Achieving this through lifestyle advice or medicines supports both primary and secondary prevention of cardiovascular disease.

• The distinction between clinic and Home Blood Pressure Monitoring (HBPM) targets follows NICE guidance. For stage 1 hypertension, a clinic target of 140/90mmHg is equivalent to 135/85 mmHg with HBPM.

• Formerly HYP008, this revised indicator reflects the recommendation in NICE guideline NG136 that clinicians exercise judgement when setting blood pressure targets for patients with frailty. Leaving patients with moderate to severe frailty outside the indicator allows practices to tailor hypertension care to the individual and their multimorbidity.

Reporting and verification

The criteria for meeting HYP010 are set out in its definition in the table above.

HYP011: based on NICE IND240

Rationale

• NICE guideline NG136 sets a treatment target below 150/90 mmHg for patients with hypertension aged 80 years and over. It also advises offering the antihypertensive medicines used for people aged 55-80 years, while accounting for co-morbidities.

• A lower treatment target established before the age of 80 years is not a reason to change or reduce treatment on reaching that age: existing treatment should continue. Maintaining longstanding treatment that is well tolerated is a different decision from initiating blood pressure-lowering treatment in someone aged 80 years and older.

• In keeping with NICE guidance, the target depends on whether blood pressure is recorded in a clinic or through HBPM. A clinic target of 150/90mmHg corresponds to 145/85 mmHg at home.

• Previously HYP009, HYP011 puts into practice the NG136 recommendation to apply clinical judgement to blood pressure targets in patients with frailty. Its exclusion of patients with moderate to severe frailty gives practices scope to individualise hypertension management around multimorbidity.

Reporting and verification

The criteria for meeting HYP011 are set out in its definition in the table above.