High blood pressure is one of the leading risk factors for premature death and disability, and can lead to stroke, heart attack, heart failure, chronic kidney disease and dementia. Conditions caused by high blood pressure cost the NHS over £2 billion every year.
By reducing the blood pressure of the nation as a whole, £850 million of NHS and social care spend could be avoided over 10 years. We know from international comparison that there is significant scope for improvement. For example, in Canada, 7 out of every 10 adults with high blood pressure are both diagnosed and managed to recommended levels whereas in England we only achieve this in 4 out of 10.
Some progress has already been made in reducing the population’s levels of high blood pressure. In the last decade, the population’s average blood pressure has fallen by 3mmHg (the units which we use to measure blood pressure), which is promising and has been helped by the successful reduction of salt in diets, thanks largely to product reformulation by the food industry. But with 5 million people in England still living with undiagnosed hypertension, there is a lot more we can do.
But with 5 million people in England still living with undiagnosed hypertension, there is a lot more we can do.
As part of our strategy to tackle this national health issue, Public Health England’s blood pressure and National Cardiovascular Intelligence Network (NCVIN) teams have joined to launch local hypertension profiles. These come in the simple format of a downloadable PDF, and shows how each local authority and Clinical Commissioning Group (CCG) is doing in detecting and treating high blood pressure by comparing its performance with that of similar organisations, the rest of its region and with the England average. It also highlights key approaches that can be taken to improve local performance and deliver better outcomes for the local population.
For the prevention of hypertension the profiles show for each local authority or CCG the magnitude of modifiable risk factors such as excess weight and dietary salt or alcohol intake (as well as the non-modifiable risk factors of age, family history and ethnicity). This will help identify how much of a potential difference can be made locally through population-level change as well as support for individual behaviour change.
For detection and management of hypertension key recommended approaches include more frequent testing in different settings, targeting high risk groups and clinical leadership. Across the board an important route to improving blood pressure outcomes is by increasing take-up of the NHS Health Check. This risk assessment and management programme for 40-74 year olds offers a systematic approach to increasing detection of undiagnosed hypertension and provides individuals with support and sign posting for behaviour change for risk factors such as smoking, being overweight, inactivity and hazardous drinking.
We hope these resources will prove useful information for local authorities and CCGs and will draw attention to the importance of addressing the local gaps in identifying and controlling blood pressure.