High blood pressure, often labeled a “silent killer,” has become a growing concern in the UK as treatment efforts by the National Health Service (NHS) stall. Once heralded as a significant success story, the management of hypertension has seen troubling setbacks, particularly exacerbated by the Covid-19 pandemic. Experts warn that the situation is critical, with many patients remaining undiagnosed and untreated.
The rise in blood pressure issues can be traced back to a combination of factors. According to Professor Ian Wilkinson, president of the British and Irish Hypertension Society, lifestyle changes and difficulties accessing healthcare have contributed to the decline in blood pressure management. He emphasized the urgency of the situation, stating, “Hypertension will kill more people in the UK than anything else. But we’ve stalled [on treating it], and we’re going backwards.”
Hypertension is defined by the pressure of blood against the walls of blood vessels. Elevated levels can lead to severe health complications, including heart attacks, strokes, and kidney failure. For years, the NHS made strides in identifying patients with high blood pressure and providing appropriate medications. A study published in BMJ Medicine highlighted that the percentage of undiagnosed patients fell from 33 percent in 2003 to 24 percent in 2011, alongside a reduction in average systolic blood pressure from 129 to 124 mm Hg over the same period.
However, progress has stagnated since then. Between 2019 and 2021, the number of undiagnosed patients increased to 32 percent, and average systolic blood pressure ticked up to 126 mm Hg. Dr. Ajay Gupta, a consultant in cardiovascular medicine at Queen Mary University of London and lead author of the study, noted that unhealthy lifestyle trends, including increased salt consumption and rising obesity rates, have contributed to this decline in hypertension management.
The consumption of salt has risen after a decade of successful reduction initiatives. Previously, average intake fell from 9.4 grams per day in 2014 to 7.6 grams, but by 2018, it climbed back to 8.4 grams. The recommended maximum daily intake is 6 grams. Dr. Gupta speculated that the increase in processed foods, which typically contain high levels of salt, has played a significant role in this trend.
The Covid-19 pandemic further complicated matters. During the height of the crisis, many patients were discouraged from seeking non-urgent medical care, resulting in missed health checks and delayed treatment. “Access to medications, access to evaluations got disrupted,” said Dr. Gupta. He indicated that the service disruption has likely had a cumulative effect on hypertension control.
As healthcare systems continue to grapple with the repercussions of the pandemic, Professor Wilkinson pointed out that the increase in obesity remains one of the most pressing factors affecting blood pressure. He noted that dietary habits have worsened, with more individuals opting for ready-made meals high in salt content.
The shift to remote consultations during the pandemic may also have contributed to patients’ reluctance to initiate blood pressure treatment. Professor Wilkinson stated that lack of personal interaction can diminish patients’ willingness to engage in treatment, as many do not feel unwell and may hesitate to take medication. “If you have a proper conversation about it, you can explain that if you treat this early and get the blood pressure to target, they will gain healthy life years,” he added.
The NHS has been approached for comment on the current state of hypertension management and the steps being taken to address the growing crisis. As the nation faces an uphill battle against rising blood pressure rates, the need for effective interventions and public health campaigns has never been more urgent.
