Beating blood pressure in the South East

Dr Mohit Sharma is Consultant in Healthcare Public Health, NHS England South East. He leads on cardiovascular disease prevention in the South East of England. He explains why awareness among both health professionals and communities is key to tackling high blood pressure post-pandemic.  



Why is high blood pressure such an important condition to tackle?
Cardiovascular diseases such as heart disease and stroke account for a substantial proportion of the burden of ill health across society, and the biggest risk for cardiovascular disease is high blood pressure. They also make a large contribution to the inequality of health outcomes. This can be measured in difference in life expectancy, which is lower for those living in greater deprivation. 

Cardiovascular disease accounts for the largest proportion of the difference in life expectancy between the least and most deprived people in England, at 22.9% for males and 19.3% for females. Over the course of the pandemic, there was an inequality in mortality from Covid-19 for those from minority ethnic communities and this was largely driven by cardiovascular causes. 

The NHS recognises the importance of cardiovascular disease and high blood pressure, and the national ambition is to diagnose 80% of those with high blood pressure and optimally treat 80% of those diagnosed. 

What are your plans for the South East?
In England, we estimate that 65.7% of those with high blood pressure have a diagnosis, which means over 1.8 million people still need to be diagnosed to reach the 80% target. In the South East, we have produced data packs for health professionals to help them find and optimally treat those with high blood pressure. 

During the pandemic, there was a reversal in the progress made in achieving optimal treatment (receiving the most effective treatment to achieve a normal blood pressure). In the South East in 2020/21, 45.5% of those with high blood pressure were optimally treated, down from 68.8% the year before. This has improved in the last year to 56.7%, but clearly much work needs to be done. This is before accounting for those who remain undiagnosed.

How can high blood pressure affect people if it’s not diagnosed and treated? 
High blood pressure is often detected during a visit to the doctor for something unrelated, as it can be entirely without symptoms. When detected it needs to be treated to achieve a blood pressure in the normal range. Undetected and untreated, it may only be diagnosed after a catastrophic event such as a heart attack or stroke. 

Is it true that high blood pressure mainly affects older people?
The risk of having high blood pressure increases with age, but those who develop it at a younger age, in their 40s, also need treatment to avoid illness. Indeed, younger people living with untreated high blood pressure risk suffering from ill health earlier.

What is being done to address high blood pressure?
Cardiovascular disease, and high blood pressure, has been recognised as a key priority nationally. This was emphasised in the 2019 NHS Long Term Plan and the national ambitions. In response to the drop in blood pressure management during the pandemic, there is intense focus on this key priority and a substantial part of the fall in those receiving optimal treatment has been recovered. 

In terms of diagnosis, the NHS is working hard to identify those who come into contact with healthcare services, but those with no symptoms and otherwise well, may not be seen and this is why awareness is very important. We support Blood Pressure UK’s Know Your Numbers! campaign to raise awareness and encourage everyone to check their blood pressure at home, in pharmacies, or in GP surgeries.

NHS England South East were a huge support to Know Your Numbers! Week this year with expert-led videos and great social media presence