Professor Kevin Fenton

Professor Kevin Fenton, Director for Health and Wellbeing at Public Health England (PHE), explains why we need to focus on combating high blood pressure.

While the link between high blood pressure and cardiovascular disease is well known, it often surprises people to learn that high blood pressure is actually the third biggest risk factor for disease and disability in England after smoking and poor diet.

Dubbed the “silent killer” as it rarely causes symptoms, high blood pressure is the biggest risk factor for cardiovascular disease and contributes to half of all strokes and heart attacks. It also increases the risks of developing dementia, heart failure and kidney disease.

Despite high blood pressure being responsible for around 75,000 deaths in England in 2015, it is all too frequently undiagnosed and under treated.

For every 10 people diagnosed with high blood pressure, 7 remain undiagnosed and untreated – accounting for more than 5.5 million people in England alone. And 1 in 3 people with diagnosed high blood pressure are not treated to target. 


It is estimated that high blood pressure costs the NHS £2.1 billion a year. This figure is even higher when you take into consideration the impact on the wider society.

The good news is that high blood pressure is preventable and we can all take steps to reduce the burden it places on the NHS.


Public health professionals have a key role to play in encouraging people to lead a healthy lifestyle. Eating a healthy balanced diet, reducing the amount of alcohol consumed, and being physically active will all help to reduce the risk of developing high blood pressure.

Excess dietary salt is one of the most important modifiable risk factors for high blood pressure. In England, the salt reduction programme started in 2004 and continues today. It has focused on reducing levels of salt in a wide range of everyday foods as this is where most salt in the diet comes from.

Salt that is added during cooking and at the table only accounts for around one-quarter of the salt we eat. Some significant reductions of up to 50% have already been achieved in some foods, such as bread.

The latest edition of Health Matters explores what local authorities can do to tackle high blood pressure. This includes:

  • developing and supporting initiatives to promote public awareness of blood pressure and its opportunistic detection
  • working collaboratively with partners across the health and social care system to maximise the benefits of blood pressure prevention, detection and management
  • promoting and improving the uptake of the NHS Health Check

PHE’s One You campaign, aimed at people aged 40-60, can help to motivate people to take steps to improve their health.  Local authorities have a crucial role to play in making sure One You meets the needs of communities across the whole of England.

Expanding and improving coverage of the NHS Health Check, available to all adults in England aged 40 to 74, can also help to pick up more cases of high blood pressure.

A large scale national evaluation of the NHS Health Check found that it picked up 1 new case of high blood pressure in every 27 checks or delivering blood pressure checks and NHS Health Checks.

Read the high blood pressure edition of Health Matters for more on what local authorities and health professionals can do to boost the prevention, detection and management of this silent killer. You can also visit the Health Matters collection page to view previous editions and to sign up to the e-bulletin.