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Health Matters - Blood Pressure

Mike Clark
Health Matters - Blood Pressure
30 November 2017

Dr Mike Clark, clinical lead for health improvement at NHS Eastern Cheshire CCG, and GP with High Street Surgery, Macclesfield

Did you know that more than a quarter of adults in England have high blood pressure?

It’s the nation’s most common long-term condition and, after smoking, is the biggest cause of disability and premature death.

In Cheshire and Wirral alone, there are thought to be 300,000 people with high blood pressure, and a further 150,000 undiagnosed. These figures are worrying because high blood pressure can cause heart attacks, strokes, and heart failure. What is more, complications from high blood pressure are estimated to cost the NHS more than £6m a year in Cheshire and the Wirral.

Yet hypertension, to use the correct medical term, is largely preventable. And that’s why NHS leaders in Cheshire and Merseyside have agreed a string of actions to prevent high blood pressure as part of their response to NHS England’s Five-Year Forward View – a blueprint for how the NHS must change to continue providing excellent, affordable care.

The actions include making blood pressure testing widely available in community pharmacies and taking steps to improve blood pressure management in GP practices. These measures are set to cost around £20,000 a year, which is negligible compared with estimated savings of around £600,000 a year from the expected reduction in the number of people needing treatment because of complications.

In fact, better management of blood pressure is expected to prevent 262 adverse health events over the first five years, made up of 74 strokes, 47 heart attacks, 103 instances of heart failure and 38 deaths.

This approach has been described by Public Health England as nationally “pace setting” while Professor Norm Campbell, a world authority on high blood pressure, has termed our plans “state of the art”.

The blood pressure prevention programme is one of three agreed by the NHS in Cheshire and Merseyside. The other two focus on tackling alcohol misuse and the growing resistance of bacteria to antibiotics. Together, these three issues are seen as the biggest challenges facing the NHS in the area.

Irresponsible drinking can cause strokes, heart disease, liver disease, brain damage, various cancers and damage to the nervous system. In addition, misuse of alcohol is associated with up to 70 per cent of A&E visits at peak times. Accordingly, actions agreed to encourage sensible drinking include targeted advice at the point of care, enhanced support for drinkers having the biggest impact on the NHS, and better sharing of information by emergency services to reduce alcohol-related violence.

Meanwhile, resistance to antibiotics is growing because of inappropriate use and has been named by the World Health Organisation as the greatest global health threat. In addition, it is Public Health England’s top priority. This is partly because of the risk of antibiotics stopping working on infections acquired during surgery.

Actions agreed to tackle resistance to antibiotics include further reducing inappropriate prescribing, encouraging all health workers to sign up as Antibiotic Guardians and improving the education of prescribers on the implications of anti-microbial resistance.

Keep an eye on this column for updates on the delivery of our prevention plans.