Urgent action needed to tackle the 'silent killer'
25 May 2005
Hypertension (or persistent high blood pressure)* is one of the most common health problems in the UK today. Arguably the most important risk factor for coronary heart disease (the UK's leading cause of premature death), and stroke (the third leading cause), people may not be aware they have it as it has no symptoms. This has earned hypertension a reputation as the 'silent killer'.
In England alone, 32% of men and 30% of women have hypertension,  and in terms of the average GP's list of 2,000 patients - about 500 have hypertension.  Despite isolated examples of good practice, prevention initiatives are thinly spread, detection is patchy and clinical protocols are poorly followed. But more than 14,000 lives could be saved each year, if adult blood pressure was reduced by just a small amount.  Hypertension can be caused by lack of exercise and poor diet, including too much salt and not enough fruit and vegetables.
Dr Alan Maryon-Davis, co-author of the toolkit said: "It's critical we do something about high blood pressure, particularly in the face of rising obesity and declining physical activity levels. For example, we know that obesity multiplies the risk of developing hypertension about fourfold in men and threefold in women, which obviously has major implications for the numbers of people dying from heart disease. Action must be taken to alert people to the risk of high blood pressure and the steps they can take to reduce it."
Tackling hypertension is essential to those national strategies for CHD, stroke, diabetes and chronic kidney disease. It also forms a key part of GMS targets. To help local primary care teams meet these targets, the Faculty of Public Health and the National Heart Forum have produced Easing the Pressure: Tackling Hypertension. Supported by the British Hypertension Society, Blood Pressure Association, Stroke Association, Food Standards Agency, and other major health organisations, the toolkit equips them with everything they need to develop local strategies to reduce hypertension.
Simon O'Neil, Director of Care & Policy at Diabetes UK said of the toolkit: "Alongside blood glucose management, blood pressure control is the key to preventing the devastating long term effects of diabetes. This initiative will help provide the tools for this challenge to be undertaken in communities all over the country." As many as 70% of adults, in England, with Type 2 diabetes have hypertension.
Paul Lincoln, chief executive of the National Heart Forum, says: "There's huge untapped potential for saving lives, both in terms of treatment and prevention of hypertension. This area of public health is very neglected in the UK. So little happens in terms of awareness raising and treatment that we have become the 'control country' for US studies. The toolkit builds on the recent work of Department of Health and Food Standards Agency pushing for salt reductions in processed foods."
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Notes to editors
1. The toolkit has been produced jointly by the Faculty of Public Health and the National Heart Forum. See here
for more information.
2. Copies of Easing the Pressure: Tackling Hypertension will be available from the Faculty of Public Health and National Heart Forum. Hard copies can be ordered from the Faculty of Public Health, 4 St Andrew's Place, London NW1 4LB T: 020 7935 0243 E: email@example.com
3. Tackling Hypertension: Easing the Pressure was written by Dr Alan Maryon-Davis and Dr Vivienne Press, and is endorsed by the following organisations:
- Blood Pressure Association
- British Cardiac Society
- British Heart Foundation
- British Hypertension Society
- Consensus Action on Salt and Health
- Food Standards Agency
- Heart of Mersey
- Institute for Health Promotion and Education
- UK Public Health Association
- Royal College of Nursing
- Royal College of Physicians of London
- Royal College of Physicians and Surgeons of Glasgow
- Royal College of Physicians of Edinburgh
- Royal Institute of Public Health
- Royal Pharmaceutical Society of Great Britain
- Royal Society for the Promotion of Health
- Stroke Association
- National Kidney Federation
* Hypertension is defined as a persistent raised blood pressure of 140/90mmHg. [4,5,6]
- Joint Health Surveys Unit. 2004. Health Survey for England 2003. Volume 2. Risk factors for cardiovascular disease. London: The Stationery Office
- National Statistics. 2005. Mid-2003 Population Estimates, England and Wales. Estimated resident population by single year of age and sex. Accessed on 7 April 2005 from: www.statistics.gov.uk/statbase/expodata/spreadsheets/D8556.xls
- Critchley J, Capewell S. 2003. Substantial potential for reductions in CHD mortality in the UK through changes in risk factor levels. Journal of Epidemiology and Community Health; 57: 243-47
- Williams B, Poulter NR, Brown MJ et al. 2004. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. Journal of Human Hypertension; 18: 139-85
- National Institute for Clinical Excellence (NICE). 2004. Hypertension: Management of Hypertension in Adults in Primary Care. Clinical Guideline No. 18. London: NICE
- Scottish Intercollegiate Guidelines Network (SIGN). 2001. Hypertension in Older People. SIGN Publication No.49. Edinburgh: SIGN