Blood Pressure: How Can We Do Better?

NHS England’s National Clinical Director for Cardiovascular Disease Prevention looks at the launch of a vital new resource:

An excellent new resource – Blood Pressure – How Can We Do Better? – has just been launched.

It has been developed by GPs, nurses and pharmacists working with partners including NHS England, Public Health England, the British Heart Foundation, the Stroke Association and the Royal College of General Practitioners.

It can be accessed at, and there is one for every CCG.

Each pack has one page of infographics that show how the CCG and local practices are performing in detection and management of high blood pressure, and show the potential for improvement. And there are two pages of practical key messages, written by fellow clinicians in primary care, that tell us how to we can improve care and outcomes for our patients … by doing things differently.

So why is this so important? Well, it’s a fact that high blood pressure affects more than one in four adults in England, and is one of the leading risk factors for premature death and disability.

Having high blood pressure is associated with half of all strokes and heart attacks. At the same time, we know that treatment is very effective – for every 10mmHg reduction in blood pressure, the risk of a life changing heart attack or stroke is reduced by 20%.

Despite this clear evidence of benefit from treatment, four in ten people with high blood pressure remain undiagnosed – that’s around 25,000 people in the average CCG who are unaware of their increased risk and not receiving treatment. And even when the diagnosis is made, treatment is suboptimal in four out of ten individuals, with their blood pressure not being controlled to the levels recommended by NICE.

Why are so many people undiagnosed and under-treated? Because although this may be core primary care, it is often not easy to do. For example, checking blood pressure may not take long and may well be clinical priority for GPs. But in the overburdened, complex world of general practice, it is often trumped by several other priorities that patients bring to their time pressured consultations.

This situation is not going to be improved by GPs working harder – we have no extra capacity at present. It will only be improved by doing things differently, and by making the system work better for ourselves and our patients.  For example, by getting more systematic about audit in practices and CCGs so that we identify the missing and under-treated, by making better use of community pharmacists to diagnose and treat high blood pressure, by promoting more self-measurement and telehealth solutions, and by use of wider settings for blood pressure checking.

Blood Pressure – How Can We Do Better? shows how this can be done. The infographics highlight at a glance the opportunity for improved detection and management in every CCG. And the key messages identify some of the practical, real world steps that can be taken at CCG and practice level to improve detection and management of high blood pressure, while at the same time minimising the burden on general practice.

Dr Matt Kearney

Matt Kearney is NHS England’s National Clinical Director for Cardiovascular Disease Prevention and a GP in Shropshire. He has been working for both NHS England and Public Health England since 2013, and has led development of the NHS Long Term Plan CVD Prevention Programme.

In particular, he has focused on driving system change to help the NHS to get serious about prevention of heart attacks, strokes and other vascular conditions – through clinical leadership, better use of data, and new ways of working that support primary care to improve outcomes for patients and communities.

Previously Matt worked as clinical and public health advisor to the Department of Health respiratory programme, and was a member of the NICE Public Health Interventions Advisory Committee from 2005 to 2013. He has a Master’s Degree in Public Health and is a Fellow of both the Royal College of GPs and the Royal College of Physicians.


  1. Ravinder Nath says:

    Today has been my second visit to my GP after 4 wks. Alarmingly my BP has been recorded 189/110 .. my GP has just upped my dose of meds and said him in another 4 wks.

    I’m worried that my BP is high and constantly have pain in my chest.
    Dr has organised me to get an ECG done.

    I am worried that I maybe in danger of have a severe heart problem. What should I do??

  2. JCS says:

    I cannot for the life of me understand how taking the blood pressure every time a patient comes to see the GP can take too long. But if – why not follow Ian’s advice (comment from 10 nov, 9.19pm) ? Leaving all responsibility as usual to the patient will make things more expensive for the NHS in the long run, not cheaper!

  3. Ian says:

    I’m not a doctor so maybe talking rubbish but if time to take a reading is the issue then why not have a BP machine in the waiting room. May not be accurate but at least it is an indicator to take into GP. Also why not put blood pressure kits into social circles e.g churches, football clubs, work places. Encourage everyone to take their BP 4 times a year. If high reading then do it once a day for a week. If average high then go to GP.

  4. KASSANDER says:

    “It can be accessed at, and there is one for every CCG.”
    If you, like I did, got lost on the journey to your CCG, try this shortcut =

  5. Ed Han says:

    Hypertension and CVD due to HTN is at epidemic proportions all over the world. The single best thing any adult can do whether at risk of HTN or not is to regularly engage with their blood pressure and monitor at home. Yet there seems to be such resistance to this simple, non-invasive prevention. I believe simplicity from mobile and artificial intelligence combined with education and insights could be the key and would love to engage others on ways to make a deep impact on this alarming chronic condition. Our solution is yet to launch but I’m motivated by anyone doing something that can reverse this trend and would love to connect.