Hypertension - signposting (2024)

Preface

This is a compilation of key existing research and evidence, including links to publicly accessible content and sites with restricted access for registered users. It is not a comprehensive list of all resources available. 

To let us know about missing resources that would be helpful, send an email to publichealthintelligence@brighton-hove.gov.uk.

Notes

All links are related to hypertension. This list is not exhaustive.

The data sources and weblinks are verified and trusted sites.

Some sources are restricted to Public Sector & NHS professionals, these are denoted with a **.

Hypertension, also described as continuous high blood pressure, can put extra strain on:

• blood vessels
• the heart
• the brain
• kidneys
• eyes

Persistent hypertension can increase the risk of serious and potentially life-threatening health conditions, such as:

• heart disease
• heart attacks
• strokes
• heart failure
• peripheral arterial disease
• aortic aneurysms
• kidney disease
• vascular dementia
• erectile dysfunction
• high blood pressure during pregnancy  

Even small reductions in blood pressure can help lower the risk of these health conditions.

Blood pressure is recorded with 2 metrics:

• the systolic pressure (higher number) is the force at which the heart pumps blood around the body
• the diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels between heartbeats when blood is pumped around the heart

Normal blood pressure ranges from 90 to 120 systolic and 60 to 80 diastolic. Low blood pressure is below these thresholds.

High-normal blood pressure is 120 to 140 systolic and 80 to 90 diastolic. High blood pressure is over 140 for systolic and over 90 for diastolic.

Image source: Hypertension campaign launches - Welcome (southeastclinicalnetworks.nhs.uk).

What causes high blood pressure?

It's not always clear what causes high blood pressure, but some factors can increase the risk, such as:

• living with obesity
• having a diet that is high in salt and low in fruit and vegetables
• not doing enough regular exercise
• drinking too much alcohol or coffee (or other caffeine-based drinks)
• smoking
• continued and serious levels of stress
• being over 65 years old
• having a relative with high blood pressure
• being of Black African or Black Caribbean descent
• living in a deprived area
• having certain underlying health conditions
• taking certain medications

Healthy lifestyle changes can reduce the risk of high blood pressure and help lower blood pressure if it's already high.

High blood pressure often has no or few symptoms. Identifying people with undiagnosed hypertension is important in helping to reduce and/or manage their blood pressure to prevent and reduce the risk of developing more serious conditions.

This has been an aim embedded in:

• recent NHS national and local initiatives such as Core 20+ Plus 5
• focused work via general practices and community pharmacies such as BP@home
• national public campaigns such as Know Your Numbers and the NHS Health Checks programme

NHS overview

The NHS provides an overview of hypertension including causes, diagnosis, treatment and prevention.

By March 2022, the prevalence of hypertension in Brighton & Hove, as recorded on GP practice registers, was 9.6% of the total population or 31,515 people. This is the 11th lowest prevalence of the 152 upper-tier local authority(1) areas in England.

This compares to a prevalence of:

• 14.1% for the South East
• 14.0% for England

The percentage of people with hypertension in Brighton and Hove is lower compared to England. There has been no significant change in the prevalence of hypertension in Brighton & Hove or England since 2012/13 (figure 1).

Figure 1: Trend - Hypertension QOF prevalence (%) (all ages) trend, Brighton & Hove and England, 2012/2013 to 2021/2022.

Source: OHID (FingerTips) - Hypertension: QOF prevalence (all ages).

Our Joint Health & Wellbeing Strategy, 2019 to 2030 (Brighton & Hove City Council) sets out our vision for the health and wellbeing of people and communities in Brighton & Hove, together with the core principles which will guide local action to deliver the vision.

It presents a shared view of:

• where we are
• the challenges and opportunities that we face

Improving Lives Together (Sussex Health & Care NHS) sets out the current ambition across NHS health and care in Sussex for a healthier future in Sussex. This includes:

• strategy
• shared delivery plans
• health and wellbeing strategies by area
• data profiles

The NHS Long Term Plan identifies cardiovascular disease as:

• a clinical priority
• the single biggest condition where lives can be saved by the NHS over the next 10 years

The NHS Long Term Plan sets the ambition for the NHS to help prevent over 150,000 heart attacks, strokes and dementia cases by 2029. The Plan outlines how the NHS, partners in the voluntary and community sector and other national organisations will meet this ambition.

The Major Conditions Strategy 2023 framework identifies 6 groups of conditions which are collectively the greatest contributors to ill health and early mortality, including cardiovascular disease (CVD). They cause over 60% of years lost to early death or lived in ill health. It recognises that people may have more than one of these conditions and aims to work on addressing similar causes and risk factors.

Core20PLUS5 (adults) – Core20PLUS5 is a national NHS England approach to inform action to reduce healthcare inequalities at both national and system levels. The approach defines a target population – the ‘Core20PLUS’ – and identifies ‘5’ focus clinical areas including hypertension case finding that requires accelerated improvement.

The JSNA executive summary is a local report on the current and future health, social care and wellbeing needs of the population of Brighton & Hove.

The JSNA executive summary includes:

• information from existing in-depth needs assessments
• health and social care data
• local views and experiences

Community Insight is a community mapping and reporting tool specific to Brighton & Hove and the surrounding areas. You can use this tool to view, compare and report on related datasets through maps, dashboards and reports at different geographic levels.

The JSNA life expectancy summary gives information about:

• life expectancy and healthy life expectancy
• inequalities and the impact of deprivation as contributing to the gaps in life expectancy

The JSNA Healthy Places summary explores the environment that shapes well-being. This summary is currently in progress.

The Hypertension Data Pack (NHS Sussex) is a compilation of local area comparisons across indicators and sub-groups.

National hypertension intelligence resources which include data for Brighton & Hove

The Hypertension Disease Profile, Office for Health & Disparities (OHID) provides national and local level data, covering hypertension prevalence and blood pressure readings.

The National General Practice Profiles, (OHID) support GPs, Primary Care Networks (PCNs), integrated care boards (ICBs) and local authorities to ensure they're providing and commissioning effective and appropriate healthcare services for their local population.

This information includes:

• individual practice profiles
• summary profiles for PCNs and other geographies

Each practice can be compared with an ICB sub-location (formerly clinical commissioning groups - CCGs), PCNs and England.

Data Explorer (CVD Prevent, NHS) is a tool from The Cardiovascular Disease Prevention Audit (CVDPREVENT), a national primary care audit informed by GP data. This tool provides open access at Sussex, Brighton & Hove, Primary Care Networks or GP practice level.

The tool also includes:

• inequalities markers
• the impact on those with learning difficulties

Adults' health: Hypertension - NHS Digital provides regular survey information that cannot be obtained from other sources. The Health Survey for England is used to estimate:

• the proportion of people in England who have health conditions
• the prevalence of risk factors and behaviours associated with certain health conditions

National intelligence resources with national-level data 

Ethnicity & Health (NHS Digital) provides:

• Health Survey England Additional Analyses
• ethnicity and health information (2011 to 2019)
• experimental statistics

Hypertension, World Health Organisation (WHO) is a global resource covering:

• an overview of hypertension, including information about symptoms and treatments
• fact sheets
• Q&As
• related initiatives

Global burden of disease (GBD), The Institute for Health Metrics & Evaluation gives a comprehensive picture of mortality and disability across countries, time, age, and sex including hypertensive heart disease and its risk factors.

The information quantifies health loss from hundreds of diseases, injuries, and risk factors so that health systems can be improved and disparities can be addressed.

Prevention of high blood pressure (hypertension) - NHS provides information on how high blood pressure can often be prevented or reduced, including by:

• eating healthily
• maintaining a healthy weight
• taking regular exercise
• drinking alcohol in moderation
• not smoking

Risk factors for undiagnosed high blood pressure in England - ONS is an analysis of risk factors for undiagnosed high blood pressure among adults living in private households, using information from the Health Survey for England (2015 to 2019).

Obesity Overview (NHS) gives information about obesity including:

• an overview and definition
• causes, diagnosis and treatment

Eating a balanced diet (NHS) gives guidance for a healthy, balanced diet. The information also explains the relationship between too much salt and hypertension.

Exercise overview - (NHS) gives exercise guidelines and workouts to help improve your fitness and wellbeing.

Alcohol misuse - (NHS) gives information about alcohol misuse including:

• an overview of alcohol misuse
• risks, treatments and guidance

Smoking Health Risks (NHS) gives information and links to conditions related to smoking.

Stress (Every Mind Matters, NHS) gives information about stress including:

• a definition of stress
• signs and symptoms of stress
• causes and tips on managing stress  

Practical Guide to Healthy Ageing (NHS & Age UK) gives advice that may help improve the health and general fitness of people of any age, but it's written to be particularly relevant for people about 70 years or older.

Hypertension & ethnicity (NHS Digital) provides:

• Health Survey England Additional Analyses
• ethnicity and health information (2011 to 2019)
• experimental statistics
• hypertension prevalence by ethnic group (page 3)

Deprivation (NHS) explains the relationship between deprivation and hypertension.   

Insight Bank - NHS, Sussex **

Insight Bank is a restricted collection of resources from local and national engagement, partner organisations and commissioners.

The resources focus on health and other population inequalities. All personal information included is anonymous.

Living with hypertension - (South East NHS) gives guidance, resources and personal stories related to living with hypertension.

Healthwatch (Brighton and Hove) (“Healthwatch”) is the independent watchdog engaging with people and patients from across the city to gather their views, experiences and ideas on health and social care services.

They work to ensure:

• NHS leaders and other decision-makers hear the patient's voice
• use the feedback to improve care

Community Works supports the voluntary, community and social (VCS) enterprise sector.

Voluntary and community organisations may have data available on their websites. Find a list of local voluntary and community organisations.

Community Works is the local VCS infrastructure organisation in Brighton & Hove. Every 5 years they publish a financial and social audit of the sector called “Taking Account”. View the most recent Taking Account report.

Blood Pressure UK is a UK charity dedicated to lowering high blood pressure. Alongside information about blood pressure, resources include:

• a learning centre
• research
• real-life stories
• FAQs

Diabetes UK is a UK charity that supports individuals, communities and professionals with research and news. This page by Diabetes UK explains the relationship between diabetes and blood pressure.

Sussex does not have a Diabetes UK office.

British Heart Foundation is a UK charity that provides:

• support with information
• a helpline
• support from the online community
• practical and emotional support
• tips for saving money and staying well

This page by the British Heart Foundation explains the risk of heart attack and stroke due to hypertension.

This page by the British Heart Foundation explains how ethnic origin can affect heart and circulatory health.

Stroke Association is a UK charity that supports people to rebuild their lives after a stroke. The charity provides:

• stroke information
• local and national support
• fundraising

This page by the Stroke Association explains why hypertension can cause a stroke, and what you can do about it.

Hypertension in adults: diagnosis and management, National Institute for Health & Care Excellence (NICE) are guidelines covering identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with type 2 diabetes.

The guidelines aim to reduce the risk of cardiovascular problems such as heart attacks and strokes by helping healthcare professionals diagnose hypertension accurately and treat it effectively.

Hypertension in pregnancy: diagnosis and management (NICE) are guidelines which cover diagnosing and managing hypertension (high blood pressure), including pre-eclampsia, during pregnancy, labour and birth.

It also includes advice for women:

• with hypertension who wish to conceive
• who have had a pregnancy complicated by hypertension

The guidelines aim to improve care during pregnancy, labour and birth for women and their babies.

Essential Hypertension - Symptoms, Diagnosis and Treatment (BMJ Best Practice) is an academic site including an overview, theory, diagnosis, management and clinical resources.  

Health matters: combating high blood pressure (Public Health England) is a professional resource that outlines how providers and commissioners can reduce the population's average blood pressure through improved prevention, detection and management.