[2011] 1.2.8 Confirm diagnosis of hypertension in people with a: clinic blood pressure of 140/90 mmHg or higher and ABPM daytime average or HBPM average of 135/85 mmHg or higher. [2019] 1.2.9 If hypertension is not diagnosed but there is evidence of target organ damage, consider carrying out investigations for alternative causes of the target organ damage (for information on investigations, see NICE's guidelines on chronic kidney disease and chronic heart failure). [2011] 1.2.10 If hypertension is not diagnosed, measure the person's clinic blood pressure at least every 5 years subsequently, and consider measuring it more frequently if the person's clinic blood pressure is close to 140/ Annual blood pressure measurement for people with type 2 diabetes 1.2.11 Measure blood pressure at least annually in an adult with type 2 diabetes without previously diagnosed hypertension or renal disease. Offer and reinforce preventive lifestyle advice. [2009] Specialist investigations for possible secondary causes of hypertension 1.2.12 Consider the need for specialist investigations in people with signs and symptoms suggesting a secondary cause of hypertension. [2004, For a short explanation of why the committee made the 2019 recommendations and how they might affect practice, see the rationale and impact section on diagnosing hypertension. Full details of the evidence and the committee's discussion are in evidence review A: diagnosis. 1.3 Assessing cardiovascular risk and target organ damage For guidance on the early identification and management of chronic kidney disease, see NICE's guideline on chronic kidney disease. 1.3.1 Use a formal estimation of cardiovascular risk to discuss prognosis and healthcare options with people with hypertension, both for raised blood pressure and other modifiable risk factors. [2004] 1.3.2 Estimate cardiovascular risk in line with the recommendations on identifying and assessing cardiovascular disease risk in NICE's guideline on cardiovascular disease. 