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April 2021

High blood pressure controlled in only two out of five despite treatment

High blood pressure is controlled in only two out of five UK patients with hypertension, despite treatment, suggests a large population based study, published in the online journal Open Heart.

People who are older (60+), of black ethnicity, and who are on relatively low incomes (£18,000/year) are less likely to have well controlled blood pressure, the findings indicate.

Despite the ready availability of inexpensive drug treatments, many people remain undiagnosed or inadequately treated, point out the researchers.

The researchers drew on baseline survey data from the UK Biobank (UKB between 2006 and 2010.

Among all 459,484 Biobank participants, over half (56%;256,203) had high blood pressure (above 140/90 mmHg).

Nearly half of those with high blood pressure (47%) were unaware of their condition, and 27% of those who were aware weren’t taking any drugs to treat it. Just under 14% were on three or more drugs to treat hypertension.

Blood pressure was controlled in only around 38% of those on treatment, meaning that nearly two thirds (62%) weren’t being treated properly.

Factors associated with poor control included older age (60+), male gender, drinking 30 or more units of alcohol a week, black ethnicity and obesity.

Low household income (£18,000 a year), low educational attainment, and manual labour jobs were also associated with poor blood pressure control.

But smoking was associated with higher odds (24%) of blood pressure control, likely due to more intensive treatment to cut the higher cardiovascular disease risk of smokers, say the researchers.

Tapela N, et al. Open Heart 2021;8:e001461.

Practice Nurse 2021;51(3):7