Millions Unaware of High Blood Pressure, Raising Risk of Serious Health Issues
A new study reveals that over half of individuals with hypertension don't know they have it, and many under treatment remain uncontrolled, increasing their risk of heart attack, stroke, and premature death.
More than half of people living with high blood pressure are unaware of their condition, a significant oversight that elevates their risk of heart attack, stroke, and early death, according to a recent study. Furthermore, only half of patients receiving treatment for hypertension have their condition under control.
Researchers from the University of Oxford analyzed the records of 1.4 million individuals participating in the UK's Our Future Health programme. Their findings indicate that over a third of adults in England have high blood pressure, with 59% of these individuals being unaware of their diagnosis. The study, published in the journal BMJ Public Health, defined high blood pressure as a reading of 140/90 mmHg or higher, or the use of blood pressure-lowering medication.
The analysis highlighted that hypertension was nearly 50% more prevalent in men than women (42% compared to 29% across all age groups) and was more common in older individuals. The authors suggest that current guidelines from the National Institute for Health and Care Excellence (Nice), which recommend measuring blood pressure over a period or at home to confirm a diagnosis before treatment and prioritizing lifestyle advice first, may contribute to a "leaky cascade of care." This process can result in numerous hypertension cases remaining undiagnosed and inadequately treated, with primary care workloads leaving limited opportunities for disease prevention.
Concerns have also been raised about the prevalence of hypertension in younger adults. The study found that 15.3% of individuals under 40 years of age have high blood pressure, a demographic ineligible for routine NHS Health Checks.
While significant progress was made in detecting and controlling high blood pressure during the 2000s, this progress has stagnated since around 2011. Indications suggest a worsening trend following the COVID-19 pandemic, potentially due to disruptions in healthcare delivery. Consequently, current hypertension prevalence levels in England are comparable to those observed two decades ago.
Wenyu Liu, lead author of the study and a medical statistician at Oxford Population Health, stated, "While hypertension is largely a 'silent killer', the current approach to detecting and treating high blood pressure is not fit for purpose." Iain Turnbull, deputy chief medical officer at Our Future Health and a practicing GP, added that many patients are either undetected or sub-optimally treated, advocating for a more proactive approach that considers initiation of treatment based on predicted cardiovascular disease risk in addition to blood pressure levels.
Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, described the study's findings as painting a concerning picture of the scale of undetected high blood pressure in the UK and the challenges in controlling it. He emphasized that high blood pressure is the leading modifiable risk factor for cardiovascular disease, contributing to approximately half of all heart attacks and strokes in the UK. Williams noted that millions are living with the condition unknowingly, missing crucial opportunities for early diagnosis and treatment. He believes that improved detection and treatment could prevent tens of thousands of heart attacks and strokes.
According to British Heart Foundation analysis of NHS data, over 11 million people in the UK have been diagnosed with high blood pressure by their GP. A spokesperson for Nice clarified that their guideline supports lifestyle advice alongside medications when needed, and does not recommend delaying treatment solely for lifestyle changes.