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Research and Projects

Hypertension

Theme: Diagnostics & Stratified Medicine
Status: Complete

Read a BITE sized summary of this project.

Background

In 2003 the prevalence of hypertension in England was 31.7% in men and 29.5% in women (NCSR 2004).  Hypertension is a major cause of cardiovascular morbidity and mortality throughout the world and is estimated to have accounted for 7.6million premature deaths worldwide in 2001. This represents about 13.5% of total global deaths. Since the prevalence of hypertension increases with age, and many societies are faced with ageing populations, management of hypertension will continue to be an increasing public health problem globally.

We have published a systematic review of nurse led interventions in hypertension and plan to extend this work by reviewing the evidence base for allied health professional led interventions to improve the control of hypertension. We aim to elucidate whether nurse or pharmacist prescribing is an important component of this complex intervention.

We have also helped to establish the prevalence of the inter-arm blood pressure difference phenomenon and its associations with peripheral vascular disease and reduced cardiovascular event-free survival. Whilst the majority of GPs are aware of this phenomenon and its use as a marker for increased cardiovascular risk, only a minority check for it and there is an implementation gap between knowledge and clinical practice. We therefore intend to develop a means of disseminating the importance of this finding along with methods for implementing the use of inter-arm difference detection in primary care.

1. Work on health professional led interventions in the management of hypertension

Objectives:

  • To review the evidence base for allied health professional led interventions to improve the control of hypertension.
  • To elucidate whether nurse or pharmacist prescribing is an important component of this complex intervention.
  • To identify areas in need of further study.

Next steps:

 2. Pilot work to establish the feasibility and rationale for a primary care intervention using inter-arm difference detection as an indicator of increased cardiovascular risk

Objectives:

  • Establish the strength of existing evidence for inter-arm difference as a sign of peripheral vascular disease.
  • Explore and pilot an educational and/or clinical intervention

Next steps:

  • Verify this potential risk marker in other representative community cohorts
  • Modelling study to look at primary care intervention
  • Develop primary care intervention for pilot study

Related news stories:

Related publications

Others Involved

Dr Christopher Clark, John Campbell, Prof Angela Shore, Prof Rod Taylor, Dr Obioha Ukoumunne

Partners

Patients
PCMD Primary Care Research Group
Peninsula NIHR Clinical Research Facility
Royal College of General Practitioners
South West GP Trust
Mid Devon Medical Practice
East Somerset Research Consortium
Cochrane Hypertension Group
University of Limoges, France
University of Edinburgh, Scotland
Northwestern University Feinberg School of Medicine, USA


Downloads

  • Case study example of the value of NIHR CLAHRC funding - PDF