Celebrating a year of transforming the management of high blood pressure

We are celebrating a year of collective impact, which is potentially benefiting thousands of patients nationwide, through delivering the national Blood Pressure Optimisation (BPO) programme, as outlined the Blood Pressure Optimisation Impact Report.

Thanks to the continued dedication of all 15 Academic Health Science Networks (AHSNs) and national coordination provided by UCLPartners, over 600 Primary Care Networks in England (nearly half) are now using UCLPartners Proactive Care Frameworks to tackle the risk factors of cardiovascular disease (CVD).

Over the last 12 months, UCLPartners Proactive Care Frameworks have enabled Primary Care teams up and down the country, supported by the AHSNs, to manage long-term conditions, such as high blood pressure, differently, at scale. The Frameworks prioritise clinical activity by stratifying patients who are at highest risk, deploying the wider workforce to reduce the workload for GPs and improving the personalised care offer for patients.

Evidence shows that optimising treatment for blood pressure and cholesterol can prevent cardiovascular events: one heart attack is prevented over five years for every 100 patients with high blood pressure and one stroke for every 67 patients. And for every 100 patients with pre-existing CVD who are treated with a statin, 10 heart attacks or strokes will be prevented.

Dr Matt Kearney, GP and Executive Clinical Director, Cardiovascular Health at UCLPartners said: “Improving the management of high-risk conditions like blood pressure is a ‘wicked issue’ that has progressed little over several decades. This work demonstrates how, together, we’re laying strong foundations, but this only the start. If we continue the spread and adoption of this work and supporting primary care to optimise blood pressure at scale, we will prevent huge numbers of heart attacks and strokes now and in years to come.”

Case-finding and optimal management for high blood pressure is one of the five clinical areas identified as requiring accelerated improvement in NHS England’s Core20PLUS5. Incidence of high blood pressure within the most deprived communities is roughly double that of the most affluent areas. The BPO programme has helped to tackle such stark health inequalities through a structured and systematic approach.

Dr Bola Owolabi, Director Health Inequalities at NHS England said: “I am delighted to see the work of the AHSNs in supporting colleagues to systematically address hypertension, and the explicit focus this programme has on tackling health inequalities. If Integrated Care Boards (ICBs) continue to prioritise support for blood pressure optimisation in communities at greatest risk, this will prevent heart attacks and strokes in these communities and reduce health inequalities due to cardiovascular disease.”

The BPO programme leaves a legacy for future programmes with a wide range of improvement and implementation resources developed both by the central team and individual AHSN teams. ICBs have been encouraged to build on this work to deliver substantial and early population health improvement to continue to shift the dial in CVD prevention.