Expanding Blood Pressure Readings to Address the Hypertension Pandemic

Around 15 million adults in the UK are estimated to have high blood pressure, but more than one third of those cases go undetected. With pressures on GPs mounting, NHS England has recently announced the role of pharmacies in checking blood pressure. If the goal of checking the blood pressure of 2.5 million more people is achieved, NHS England suggests it could prevent 3,700 strokes and 2,500 heart attacks, saving 2,000 lives, in the next five years.

Individuals are also being encouraged to monitor their own blood pressure readings during Blood Pressure Awareness week. This year’s ‘Know your Numbers!’ week – running from 6th to 12th September – is raising awareness of high blood pressure, encouraging all UK adults to get a blood pressure check.

Hypertension Risk

Blood Pressure UK refers to hypertension (high blood pressure) as the forgotten pandemic. High blood pressure is responsible for more than half of all strokes and heart attacks in the UK – and is the third biggest cause of disease, leading to kidney disease, vascular dementia and mobility problems. It costs the NHS £2.1 billion every year.

One of the challenges in raising awareness of high blood pressure is that patients rarely experience symptoms, although shortness of breath and unexplained fatigue can occur. As a result, many people have no idea they have hypertension until they experience a heart attack or stroke. High blood pressure is, however, treatable – both with lifestyle changes, including diet and exercise, and medication. Which is why the charity is encouraging individuals to know their blood pressure numbers, just as they know their height or weight.

Blood pressure is recorded in two numbers – systolic (the top number), the highest level blood pressure reaches as the heart beats, and diastolic (the bottom number), the lowest level it reaches as the heart relaxes. Readings between 90/60mmHg and 120/80mmHg are deemed healthy, with patients at a lower risk of heart disease and stroke.

Routinely checking blood pressure figures and knowing that 130/80 mmHg is now considered to be hypertension (it was previously 140/90mmgHg), will encourage individuals to take steps to stay healthy and avoid the risk of life-changing illness.

Improving Understanding

This change to the definition of hypertension is a direct response to better understanding of hypertension and its comorbidities – understanding provided by detailed analysis of anonymised longitudinal patient databases, such as The Health Improvement Network (THIN®), a Cegedim database.

THIN® includes over 107.5 million blood pressure test results, relating to over 11.5 million patients, providing a depth of information relating to hypertension and comorbidities. Analysis of THIN® data confirms that 14% of active patients have a diagnosis of hypertension.

Equal numbers of men and women are currently living with hypertension, according to THIN®. However men are more commonly diagnosed earlier, with the median age of diagnosis 60 for men, and women tend to live longer and are diagnosed later in life, with the median age of diagnosis for women 64.

There are also clear gender differences in the diagnosis of comorbidities. For example, 18% of active patients with hypertension also have chronic kidney disease in THIN® – a significantly higher number then the general prevalence of chronic kidney disease in the UK, which is 3.2%. 58% of these patients are male.

13% of active patients with hypertension also have coronary heart disease in THIN® – compared to the 3.1% general prevalence of coronary heart disease in the UK. 60% of these patients are male. 8% of active patients with hypertension also have had a stroke in THIN®, compared to the 1.8% prevalence of stroke in the UK. 52% are male.

As NHS resources focus on the backlog in care and the challenges of supporting those with Long Term Conditions (LTC) such as coronary heart disease and chronic kidney disease, this insight provides valuable support for clinicians faced with the challenge of prioritising care towards those in the greatest need.

Capturing Knowledge

Traditionally, patients have relied on GP practices for routine blood pressure checks – although accurate home monitoring kits are widely available. From October, blood pressure checks will also be offered to over-40s by high street pharmacies in a move the NHS hopes will prevent 2,000 deaths from heart attacks and strokes. Pharmacists will be asked to identify patients and shoppers who may be unaware of their risks and offer them checks, as well as providing lifestyle advice to people at risk of such conditions.

Where high readings are found, cases will be referred to GPs for treatment with drugs to lower the blood pressure. Doxazosin (88%) is by far the most common anti-hypertensive medication prescribed in 2020, according to THIN® analysis.

Ensuring high readings are referred to GPs and recorded in the patient’s record is key to ensure this vital longitudinal patient information is accurate and available. Using epidemiological data such as THIN® to track individuals will also help to better understand the value of these strategies – including the expansion of blood pressure recording and the level of prescribing required to manage hypertension.

About THIN®

THIN® is an unobtrusive medical data collection scheme that contains anonymised longitudinal patient records for approximately 6% of the UK population. It is the key driving force behind enabling advancements in patient care and outcomes, with one of the most respected and reliable data sources for anonymised primary care records

New call-to-action