Hypertension Quick Guide


Hypertension (persistent high blood pressure) is an important public health challenge worldwide because of its high prevalence and the associated risk of Cardio Vascular Disease (CVD). It is one of the most important modifiable risk factors for stroke, ischaemic heart disease (such as angina, heart attacks, and heart failure), and renal disease, and is one of the most preventable and treatable causes of premature deaths worldwide (Source: World Health Organization).

54% of strokes and 47% of heart attacks worldwide are attributable to high blood pressure (1). A meta-analysis (a study that looks at multiple other study outcomes) in 2016 showed that a 10 mm Hg reduction of systolic blood pressure reduced the risk of major cardiovascular disease events by 20%, coronary heart disease by 17%, stroke by 27%, heart failure by 28%, and death from all causes by 13%.


High blood pressure is defined by NICE as a systolic blood pressure (SBP) at or above 140mmHg or diastolic blood pressure (DBP) at or above 90mmHg or an average home reading less than 135/85.


30% of adults have hypertension (high blood pressure), including 15% with untreated hypertension. Overall prevalence was at similar levels for men and women.

The prevalence of total hypertension increased with age, from 9% of adults aged 16 to 44 to 60% of adults aged 65 and over.

Short and long term consequences of high blood pressure

Short and long term consequences

Stroke, Heart attack

Long term consequences

Heart Failure, atrial fibrillation, Valve damage, Kidney Damage, Dementia, Diabetes mellitus, erectile dysfunction, stroke, or heart attack

How we manage high blood pressure at West Park Surgery

We have over 17,000 patients registered at West Park Surgery, of that over 2,700 (15%) of the patients at the surgery have high blood pressure diagnosed.

We offer NHS health checks to all patients over 40 years old which screens patients for early signs of high blood pressure, diabetes, or elevated cholesterol. Three of the major risk factors for heart attacks and strokes.

If you are found to have high blood pressure in a clinic, ie your blood pressure is over 140/85. You will be asked to do a week of home blood pressure readings. You can purchase your own blood pressure machine or borrow one from our reception team. If your readings at home are over 135/85 on average we will invite you back in for diagnostic blood tests and an ECG. If those tests are normal you will then be added to the surgeries virtual ward round programme.

This service designed in house is a leading service across Derbyshire for managing high blood pressure. Our team of Doctors, Nurses, HCAs, Pharmacist prescribers, and pharmacy technicians will review your blood pressure readings and blood results. Then following the NICE Hypertension guidelines suggest the initiation of medication to help reduce your blood pressure. We will also discuss and encourage you around other ways to improve and reduce your blood pressure and overall risk for a cardiovascular event. This includes stopping smoking advice, weight management support, discussions around exercise and fitness.

Medications and monitoring

If you choose to try and improve your blood pressure through diet and lifestyle means we will advise you on goals to work towards and then suggest we recheck your blood pressure in 3 or 6 months time to see if you are making improvements.

If you agree with management with medications we will follow the NICE hypertension guidelines for our drug selection and stepwise approach until blood pressure is managed. Between 20-25% of patients nationally will be able to have their pressure controlled with just one blood pressure medication and as such the majority of patients will need two or more medications to control their pressure.

When starting medication our pharmacy technician will discuss side effects and further monitoring of your pressure and in some cases blood tests with you.

We will follow you up regularly until we have your pressure under control then you will be called for an annual hypertension review to ensure your pressure is kept controlled.

If at any point you would like to discuss your management of your high blood pressure the surgery pharmacist team is happy to have an appointment with you to discuss these appointments are pre-booked and we ask you to contact reception after 2pm to arrange a routine appointment.


The biggest risk factors that you as a patient can control are as follows.

Smoking: If you smoke please stop smoking: smoking increases your blood pressure and through other ways increases your risk for a heart attack or stroke. Support can be found at https://www.livelifebetterderbyshire.org.uk/services/stopping-smoking/stopping-smoking.aspx

Weight: being overweight or obese increases your risk for heart disease, diabetes, and cancer. We would encourage all patients who’s BMI is over 30 to seek support for how to reduce this. Support can be found at: https://www.livelifebetterderbyshire.org.uk/services/losing-weight/losing-weight.aspx

Alcohol: we recommend that men and women do not consume more that 14 units per week and this is spread out across the week. Please note that on average alcohol strengths for wine and beer has increased over the past 10 years so you might be consuming more units than you thing. Please check your units using the following calculator: https://alcoholchange.org.uk/alcohol-facts/interactive-tools/unit-calculator

If you feel you would need further help and support with reducing your alcohol consumption please discuss this with the surgery team.

Exercise: Increasing your exercise and staying consistent helps to reduce the chance of a heart attack. The national guidelines for this is 150minuets of vigorous exercise per week. We all enjoy different forms of exercise and there is no exercise that is better than any other so please find what you like and do it often.

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059018/#:~:text=High%20blood%20pressure%20(BP)%20is,the%20leading%20cause%20of%20mortality.&text=Approximately%2054%25%20of%20strokes%20and,are%20attributable%20to%20high%20BP.

2 https://evidence.nihr.ac.uk/alert/lowering-blood-pressure-reduces-the-risk-of-heart-disease-stroke-and-death/

3 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/375985/20141018_Tackling_high_blood_pressure_-_FINAL_INCL_LINK_CHANGES.pdf

4 https://www.nice.org.uk/guidance/ng136