CVD is one of the main contributors to the gap in life expectancy, accounting for approximately 20% of the difference between the most and least deprived communities in Hertfordshire and west Essex and across the country. It is largely preventable and the NHS Long Term Plan identified it as the single area that can save the most lives.

The importance of detecting hypertension

High blood pressure, or hypertension, is a key risk factor for CVD, with at least 50% of heart attacks and strokes being associated with it.

Hypertension usually has no symptoms which highlights the importance of people having their blood pressure checked regularly. It is estimated that 50% of people with hypertension are currently undiagnosed.

Although the effect of a single instance of high blood pressure is associated with higher disease risks, the assessment of blood pressure trends for an individual provides a valuable understanding of the associations between blood pressure and hypertension-related outcomes, such as stroke.

Our work in Hertfordshire and west Essex

Hertfordshire and West Essex’s system-wide work to detect hypertension has delivered measurable improvements in cardiovascular health, bringing blood pressure checks into the heart of communities.

Local data showed an opportunity to improve both disease detection and treatment to target, with an estimated 200,000 people in our area with undiagnosed hypertension. In particular, people from Black and mixed ethnicity and people living in areas of higher deprivation were at increased risk of poor outcomes because we know that fewer people in these groups attend checks and monitoring appointments.  Fewer people in our area had a blood pressure reading on their record, compared to both regional and national figures – a consistent trend for the past five years. If we were to achieve our ICB’s ambition to ‘increase healthy life expectancy and reduce inequality’ we had to drastically improve the detection of undiagnosed high blood pressure. 

Our work delivered these headline results:

• 127,000 more home and ambulatory BP readings sent to practices in 2024/25 compared to 2022/23.
• 62,845 pharmacy BP checks (March 2024 – February 2025, latest data)
• 2,914 BP checks offered in dentists and opticians
• 8,000 BP checks in acute and community providers – making every contact count across outpatient services   
• BP checks in 20 new VCFSE locations including night shelters, places of worship and support hubs – organisations trusted by people often marginalised from mainstream healthcare.

Hypertension insight packs for PCNs

GP practices are encouraged to review the data packs for their primary care network (PCN).they contain details of hypertension prevalence and resources to help practices identify miscoded patients and target those most likely to have undetected hypertension.  

• Primary Care Network packs – East and North Hertfordshire – Herts and West Essex ICS
• Primary Care Network packs – West Essex – Herts and West Essex ICS
• Primary Care Network packs – South and West Hertfordshire – Herts and West Essex ICS

Hypertension detection in pharmacies

Anyone aged 40 and above can ask at a participating pharmacy for a free blood pressure check. GP practices can also refer any patient over 18 for a blood pressure or ambulatory blood pressure check. There are more than 230 pharmacies in Hertfordshire and west Essex offering this service.