Richard Forsyth: New approach to tackle and prevent Scotland’s ‘silent killer’ a success

Almost a third of adults in Scotland have high blood pressure, a condition so serious it’s implicated in half of all strokes and heart attacks.

The Scale-Up BP Project is helping thousands of people in Scotland with high blood pressure to better monitor and manage their blood pressure at home, without the need to visit the surgery

And yet worryingly, high blood pressure is something many of us don’t even realise we have and those who do, often aren’t getting their blood pressure (BP) down to recommended levels.

Left undiagnosed and uncontrolled, high blood pressure can have devastating consequences and lead to heart failure, dementia and kidney failure. It’s why it’s often referred to as “Scotland’s silent killer”.

Tackling it requires a co-ordinated approach. Key issues include the need to ensure people are taking their blood pressure medication as prescribed, encouraging them and the wider general public to make and sustain positive lifestyle choices and to ensure that health care professionals have the information and training that they need to support people with the condition

Richard Forsyth, BHF Scotland’s Health Service Engagement Lead

A great deal of work is already being carried out across Scotland to find and test new approaches. One such example is the Scale-Up BP Project – which is helping thousands of people in Scotland with high blood pressure to better monitor and manage their blood pressure at home, giving them more control and a greater understanding of their condition.

The project – a collaboration with NHS Lanarkshire, NHS Lothian, NHS Western Isles, the University of Edinburgh and NHS 24 which was jointly funded by the BHF and Technology Enabled Care (TEC) Programme between January 2018 and December 2019 – used a system that is simple and convenient to use.

It involves a person checking their blood pressure at home for an agreed period of time and simply texting the readings to the digital health system. If they are outside the pre-agreed parameters, they will be advised what action to take. Clinicians can also view real time information about patients at any time.

The project has produced some very positive results, with evidence showing that supervised tele-
monitoring improves outcomes in the management of high blood pressure.

The task now is to support 
frontline staff to implement this as routine practice in primary care and beyond so that people become more involved in managing their own blood pressure and critically in a way that does not increase workload for frontline staff like GPs and practice nurses.

Such has been its success, the project is being expanded extensively across Scotland and the team’s pioneering work has also been recognised with a major award at the 2019 General Practice Awards in London, which is fantastic news and a true testament to the hard work of all those involved.

The Scale-Up project runs alongside the work of the new High Blood Pressure Task Force which was set up last year, following an inquiry in 2018 by the Scottish Parliament’s Cross-Party Group on Heart Disease and Stroke.

The inquiry, which BHF Scotland was part of, looked to explore what was required to tackle high blood pressure in Scotland and to develop a co-ordinated approach to better prevent and detect high blood pressure, optimise its treatment, and encourage supported self-management of the condition.

High blood pressure is a very common condition that can have devastating outcomes but it can often be managed by making positive lifestyle changes before being prescribed medication.

That is why we want more people to know their blood pressure, what the readings mean and how best to manage the condition.

Improving blood pressure control across Scotland is a complex undertaking but taking these new approaches to radically reshape blood pressure detection and management should a have powerful impact on the health of a nation, and could bring about improvements which could save and improve the lives of thousands of people in Scotland.

Richard Forsyth, BHF Scotland’s Health Service Engagement Lead