Hypertension management remains a priority during the COVID-19 restoration period: Reflections for May Measurement Month

In this blog, Shahed Ahmad, our National Clinical Director for Cardiovascular Disease (CVD) Prevention, considers how home blood pressure management is an important step to support the NHS to recover after the pandemic. 

Over the past year COVID-19 has claimed more than 100,000 lives in England, many among deprived communities and those from minority ethnic backgrounds. Even before the pandemic though, cardiovascular disease was claiming 136,000 lives a year and similarly impacting the same groups. This is compounded by the fact that patients with cardiovascular risk factors and established cardiovascular disease represent a vulnerable population when suffering from COVID-19.

NHS England and NHS Improvement prioritised hypertension management during the pandemic to support people who are vulnerable to becoming seriously ill with COVID-19, to better manage their blood pressure at home. There are over eight million people diagnosed with hypertension in England and it is a major risk factor for cardiovascular disease. Home blood pressure monitoring ensures that patients can manage their high blood pressure well and remotely, as it enables patients to measure and share their blood pressure readings with their GP without the need to visit the practice. In addition, evidence supports the use of self and telemonitoring of blood pressure vs normal care in primary care as it is cost effective (McManus et al., 2018), saves GP time (Hammersley et al., 2020) and reduces incidence of clinical events such as death, heart attack or stroke (Margolis et al., 2020). In fact, it is estimated that regular home blood pressure monitoring across a population of 50,000 patients could prevent up to 300 heart attacks and 477 strokes over three years.

Since October 2020, NHS England and NHS Improvement, alongside NHSX have been distributing home blood pressure monitors to CCGs across England, intended to be available for patients with poorly controlled hypertension, through their GP or community-based clinical team. Patients can benefit from using a monitor at home to manage their blood pressure readings more effectively and being able to send their readings instantly to their GP to review.

This is an important step to support the NHS and the people we serve during the COVID-19 restoration period.  It’s also one part of a wider programme of work called NHS @home, supporting people to have better connected, more personalised care at home, wherever that may be, and providing proactive frameworks to help restore care at scale.

Today, NHS England is supporting World Hypertension Day and the International Society for Hypertension’s May Measurement Month campaign, which aims to increase high blood pressure awareness in all populations around the world and a focus on accurate blood pressure measurement. We are also raising the profile of home blood pressure monitoring specifically, as an important measure at this time.

I should also mention that the National Cardiovascular Intelligence Network have produced Public Health England’s CVD prevention packs to support our national ambitions for CVD prevention which will serve as a huge source of support to systems. The updated packs include each sustainability and transformation partnership’s (STP) data on hypertension and atrial fibrillation detection and treatment (based on QOF 2019/20); along with charts on behavioural risk factors and NHS health checks, with inequality breakdowns shown where available. Each pack contains STP, clinical commissioning group (CCG) and practice level information.

COVID has significantly impacted communities, specifically minority ethnic and deprived communities, and so does CVD. It is a major killer but it can be tackled through preventative interventions, such as home blood pressure management and using data to target the areas that need the most support, but to achieve this, national and regional teams need to work together alongside the community. This is how we’re overcoming COVID-19 and this is how we’ll tackle CVD.

Dr Shahed Ahmad

Shahed Ahmad, National Clinical Director for Cardiovascular Disease Prevention at NHS England.

Dr Shahed Ahmad is an NHS England Medical Director in the South East Region where he is the Responsible Officer for over 3000 GPs. Shahed was educated at Corpus Christi College, Cambridge and University College and Middlesex School of Medicine. Shahed did his MSc in Public Health at the London School of Hygiene and Tropical Medicine and his leadership training at the London Business School. Before working for NHS England and NHS Improvement, Shahed was a Director of Public Health and led on cardiovascular risk reduction in a number of boroughs. Since joining NHS England, Shahed developed the NHS@2030 programme for GPs in South Central (a number of whom are now clinical directors of primary care networks) and developed the Hampshire Thames Valley Leadership Forum.