Researchers from Oxford Population Health analysed clinic blood pressure measurements collected by Our Future Health, the UK's largest health research programme, from participants who enrolled between 2022 and 2025. The findings paint a stark picture of how many cases of hypertension in England remain undetected, untreated or inadequately controlled, despite hypertension being one of the most important causes of stroke, heart disease and premature death.
Hypertension was defined by World Health Organization criteria using systolic blood pressure of 140 mmHg or greater, diastolic blood pressure of 90 mmHg or greater, or use of blood pressure-lowering medication. Using this definition, the team assessed how many participants had high blood pressure, how many were diagnosed and were treated, and how many had their blood pressure controlled.
Key findings:
Despite longstanding clinical guidance, current estimates of hypertension awareness, treatment and control in England have not improved in recent decades. The authors argue that the current NICE guidelines, which require multiple confirmatory blood pressure readings before a diagnosis is confirmed and recommend lifestyle advice ahead of drug treatment, result in many cases of hypertension never being properly detected, treated or controlled.
Wenyu Liu , Medical Statistician at Oxford Population Health and lead author of the study, said ‘While hypertension is largely a “silent killer”, the current approach to detecting and treating high blood pressure is not fit for purpose.
‘This isn't a problem confined to a particular group; it's substantial across almost every demographic we examined. Even among younger adults, who currently aren't eligible for an NHS Health Check, over 15% already had high blood pressure. This underscores the need for population-wide prevention strategies alongside targeted treatment for people at high cardiovascular risk.’
Iain Turnbull , Deputy Chief Medical Officer at Our Future Health, Clinical Research Fellow at Oxford Population Health, and GP said ‘Our Future Health is a valuable resource for research on blood pressure and the findings reflect what we see day to day in general practice.
‘Many patients with high blood pressure are undetected or are sub-optimally treated. There is a need for a more proactive approach to detection of high blood pressure and to consider initiation of treatment based on predicted risk of cardiovascular disease in addition to levels of blood pressure.’
Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, said ‘This study paints a concerning picture of the scale of undetected high blood pressure in the UK, and the challenges of keeping blood pressure under control in those already receiving treatment.
‘High blood pressure remains the leading modifiable risk factor for cardiovascular disease, linked to around half of heart attacks and strokes in the UK. The worrying reality is that millions of people are still living with the condition without knowing it and missing opportunities for early diagnosis and treatment.
‘Better detection and treatment could help tens of thousands of people to avoid a preventable heart attack and stroke. But to achieve this, we will need to rethink how we identify, treat and support those at-risk so that blood pressure checks and effective treatment can benefit everyone.’
ENDS
Notes to editors
The study , Hypertension prevalence, detection, treatment and control among 1.4 million adults in England: a cross-sectional analysis from the Our Future Health study in 2022–2025 , will be published in BMJ Public Health at 23:00 BST on Wednesday 23 September: http://doi.org/10.1136/bmjph-2025-004815
For further information or for interview requests , please contact:
Anne Whitehouse , Director of Communications and Public Engagement, Oxford Population Health, +44 (0)1865 289474, email anne.whitehouse@ndph.ox.ac.uk
About Oxford Population Health
Oxford Population Health (the Nuffield Department of Population Health at the University of Oxford) investigates the causes and prevention of disease. The department has around 1000 staff, students and academic visitors working in a number of world-renowned population health research groups, including the Cancer Epidemiology Unit (CEU), Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Translational Epidemiology Unit, and other groups working on public health, health economics, ethics, and health record linkage. It is also a key partner in the Oxford University Big Data Institute.
About Our Future Health
Our Future Health is the UK’s largest ever health research programme, designed to enable the discovery and testing of more effective approaches to prevention, earlier detection and treatment of diseases. It is collecting and linking multiple sources of health and health-relevant information, including genetic data, across a cohort of up to 5 million people that truly reflects the UK population. Identifiable data, such as name, address and date of birth, are removed from samples and health-related data, including genetic data, and stored separately in a secure data store. Deidentified data will only be made available for health research approved by our Access Board within secure environments, known as trusted research environments (TREs), that we have accredited and that meet strict security criteria.
Our Future Health is a world-leading resource for academic and commercial researchers to undertake discovery research on early indicators of disease. Researchers can also use the Clinical Research Recruitment Service to contact participants on a risk-stratified basis for secondary studies.
BMJ Public Health
Data/statistical analysis
People
Hypertension prevalence, detection, treatment and control among 1.4 million adults in England: a cross-sectional analysis from the Our Future Health study in 2022–2025
23-Sep-2026