Helping patients achieve better blood pressure control

The GM CLAHRC has been working with a number of GP practices across Greater Manchester to improve patients blood pressure control through the implementation of blood pressure self-monitoring.  The project, which started in April 2012, was prompted by initial research which has showed that self-monitoring can lead to a small but significant reduction in systolic and diastolic patients’ blood pressure.

High blood pressure is a key risk factor for cardiovascular disease and its management is one of the most common interventions in primary care, accounting for approximately £1 billion in drug costs alone in 2006. However, information collected at the start of the GM CLAHRC’s Blood Pressure Self Monitoring Project indicates that, in common with national data1, the blood pressure of a significant proportion of patients with hypertension is not controlled to the target levels recommended by the National Institute for Health and Clinical Excellence (NICE).

Leading the project, Knowledge Transfer Associate from GM CLAHRC, Katy Rothwell, said: “Our dataset, collected from 7 GP practices at the start of the project in April 2012, demonstrated that the blood pressure of nearly half of all patients on the practices’ hypertension registers was not controlled to the target level recommended by NICE.  Controlling patients’ blood pressure is important.   Each 2 mmHg rise in systolic blood pressure is associated with a 7% increased risk of mortality from ischaemic heart disease and a 10% increased risk of mortality from stroke.”

“Our data also showed that a patient’s target blood pressure (as defined by NICE) was a key predictor of blood pressure control.  Patients’ blood pressure targets vary depending on a patient’s age and the nature and number of other clinical conditions they may have (e.g. type 2 diabetes, chronic kidney disease).  Our data indicated that, on the whole, the lower the blood pressure target, the less likely it was that a patient’s blood pressure would be controlled to the recommended level.”

This project is scheduled to end in April 2013, with a full evaluation of the project planned to be completed in Autumn 2013.

1Health Survey for England, 2010 http://www.ic.nhs.uk/pubs/hse10trends