A new study from Queen Mary University of London indicates that England has experienced a reversal in the progress made during the 2000s regarding high blood pressure prevention, diagnosis, and management.
Researchers analyzed data from over 67,000 adults collected through the annual Health Survey for England between 2003 and 2021. The study found that improvements in high blood pressure rates, undiagnosed hypertension, and treatment control stalled after 2011 and worsened following the Covid-19 pandemic.
The research, published in BMJ Medicine, reported that high blood pressure prevalence declined from 37.8 percent in 2003 to 33.2 percent in 2018. However, there was little improvement after this period up to 2021. The rate of undiagnosed hypertension dropped from 32.6 percent in 2003 to 23.7 percent by 2011 but increased again to reach 32.4 percent by 2021—levels last seen two decades ago.
The proportion of individuals with diagnosed high blood pressure who achieved adequate control rose significantly until 2011 but did not improve meaningfully afterward, falling from 63.1 percent in 2011 to 56.8 percent by 2021. According to the study's estimates, about five million adults in England may currently have undiagnosed high blood pressure, while another five million have diagnosed but uncontrolled hypertension.
High blood pressure continues to be the primary cause of cardiovascular deaths in England. The authors observed that premature cardiovascular mortality has risen recently and is closely linked with increasing cases of poorly controlled or undiagnosed hypertension.
They suggest that stagnation in managing blood pressure is influenced by several factors such as higher obesity rates, greater average salt consumption, growing socioeconomic inequalities, and more prevalent mental health disorders.
The impact of the Covid-19 pandemic was also assessed; researchers found a notable decline in detection and management of high blood pressure between 2019 and 2021 due to disruptions like limited access to routine primary care and fewer opportunities for measuring blood pressure.
To address these setbacks, the authors recommend coordinated actions including a stronger national salt-reduction initiative, better diagnostic service access, effective strategies for improving medication adherence barriers, and renewed clinical education efforts aimed at reducing therapeutic inertia.
