undiagnosed high BP - PMS Instruments

Undiagnosed High Blood Pressure – The Silent Killer

According to new estimates produced by The British Heart Foundation, four million people under the age of 65 in the UK are living with untreated high blood pressure with further analysis finding that 1.3 million of these people are under the age of 45.

As well as significantly raising the risk of heart attack and stroke, it can also be the cause of an increased risk of vascular dementia, raised cholesterol and diabetes.

Getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

Checking your own blood pressure with an A&D Medical clinically validated BP monitor is an easy and inexpensive way to understand if you are one of the millions of people across the UK living with undiagnosed high blood pressure and giving you the information needed to get the correct treatment and advice.

Taking a blood pressure reading takes less than 5 minutes and can be done in the comfort of your own home not just in a doctor’s surgery or pharmacy.

Many people assume that high blood pressure is generally associated with older, overweight or unfit people. Though these conditions can lead to a high risk of heart attack and stroke, many people with an active lifestyle can also fall victim to this silent killer.

A considerable number of young people in the UK aged 16 to 24 unknowingly have risky high blood pressure too.

Stessful workplace environments are a major cause of high blood pressure with busy people all too easily putting the issue to the back of their minds.

Ordering an A&D Medical clinically validated BP monitor and getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

With waiting lists at an all time high and the NHS under more pressure than ever before, acting now could give you the greatest opportunity to receive the life-saving treatmment you may need.

PMS Instruments stock a vast range of blood pressure monitors with different cuffs sizes to suit every individual.

So don’t become a statistic, order yours today and give yourself the best chance of taking the necessary steps to avoid long-term harm.

Identify More Hypertensives With A Waiting Room Blood Pressure Monitor

Guidance on preventing cardiovascular disease (CVD) was originally published in 2019 and was updated this year. Optimal treatment of AF, high blood pressure and raised cholesterol is highly effective in preventing CVD events.

Over 40% of people with high blood pressure remain undiagnosed and of those diagnosed with high blood pressure, only 67% are optimally managed.

How do we diagnose and manage more effectively?

GP Practices are encouraged to actively screen patients and seek out hidden hypertensives. To the average practice this could mean hundreds of extra appointments for a simple blood pressure measurement.

They need help in the form of the easy to use, clinically validated A&D Medical TM-2657P waiting room blood pressure monitor.

Originally the idea of allowing patients to measure their own blood pressure was greeted with scepticism by some clinicians, but practice managers were quick to see the advantages.

Ideally located in a quiet corner of the waiting room, this type of monitor is designed for professional high volume use and automatically prints a reading, with the date and time, on a small slip of paper.

The patient usually shows this reading to the doctor or nurse at the beginning of the consultation and if the readings are too high or low they can then re-measure. In some practices patients hand results to a member of the reception team, who record it electronically for later review.

For practice managers, they offer good management and effective use of resources freeing clinical staff for other roles where they may be better utilised. Some practices report they ‘save’ up to 100 appointments per month on average.

For patients the feedback is positive and the monitors promote understanding and compliance.

Recently we have been involved in a couple of projects looking to target patients who don’t visit a GP regularly or have access to another healthcare provider. TM-2657P blood pressure monitors have been placed in public access buildings like Libraries and Pharmacies.

They have identified new undiagnosed hypertensives with elevated blood pressure and helped manage existing hypertensive patients promoting medication compliance.

Community Pharmacies to Offer Hypertension Case Finding ABPM Service

According to the Pharmaceutical Services Negotiating Committee (PSNC) Hypertension is one of the biggest risk factors for CVD (Cardio Vascular Disease) affecting 7 million people and represents a financial burden of approximately £9 billion a year to the NHS.

The NHS Long Term Plan commits the NHS to reducing morbidity and mortality due to CVD, tackling inequalities and a shift towards prevention strategies. It specifically states that community pharmacy, in collaboration with other providers, will provide opportunities for the public to check on their health through tests for high BP and other high-risk conditions.

The 2019-2024 Community Pharmacy Contractual Framework agreed to pilot a model for detecting undiagnosed CVD in community pharmacies through NHS England and NHS improvement’s Pharmacy Integration Fund (NHSE&I). The majority of the pilot scheme started after March 29^th when Covid restrictions were eased. The scheme covered 6 Primary Care Networks (PCN). 35 pharmacies participated in 4 geographies. The pilot sites included rural and urban areas, areas of high ethnicity and areas of mixed deprivation/affluence. The pilot scheme ended in September 2021.

As a result of the, success of the pilot scheme, from 1^st October 2021 a new Hypertension case finding service can be offered by UK pharmacies.

Which monitor should a pharmacist purchase?

The Meditech ABPM-06 ABPM monitor meets and exceeds the list of considerations the PSNC suggests pharmacists consider when purchasing an ABPM on their website. The non-exhaustive list includes;

Is maintenance and training included in the purchase price?

PMS Instruments includes remote support and training. We can also provide a standard operating procedure (SOP)

Calibration versus replacement cost and the carbon footprint of both activities;

As a Meditech Official Service Partner we offer a fixed price service and calibration plan after the first two years

Frequency/cost of cuff replacement and other consumables;

Meditech cuffs are latex free wipeable and hygienic. Meditech ABPM monitors can use re-chargeable batteries reducing running costs

Complexity of use – time taken to use (and explain use, in the case of ABPM);

The easy-to-use Meditech ABPM-06 monitor has been designed with comfort in mind and based on feedback from thousands of customers worldwide

For ABPM, the usability of any inclusive software to support set up for the patient and interpretation of readings. Additionally, software and hardware compatibility with existing pharmacy IT systems needs to be considered, e.g., can you plug the meter into a USB port on a PC in the pharmacy.

Meditech ABPM-06 has automatic textual analysis to the latest NICE guideline classifies into 1 of 3 hypertension classifications, as well as number of successful readings determines if recording has been successful. It automatically generates average readings for rapid standard assessment. Comes with a standard USB PC cable for genuine plug and play operation.

ABPM must be validated by the British and Irish Hypertension Society (BIHS)

Meditech ABPM-06 is listed on the BIHS website and is FDA and CE approved with an AA grade

The Meditech-06 from PMS Instruments has a whole list of features including free 2 Year Premier Support including remote training and technical support. The Meditech-06 is Supplied with

• Adult (25-32cm) cuff
• Large adult (32-42cm) cuff
• USB PC cable
• CardioVisions analysis software
• Carry pouch, shoulder strap, waist belt
• Quick start user instructions
• 3-year warranty on monitor

To discover even more reasons to purchase a Meditech ABPM-06 from PMS Instruments click HERE

Cardiovascular disease a national call to action

The fight begins against the nation’s biggest killer. Prevention is better than cure.

That’s the message from the latest guidance jointly released today by Public Health England and NHS England.

They have agreed ambitions and a goal over a 10 year period to improve the detection and treatment of (A) atrial fibrillation, (B) high blood pressure and (C) high cholesterol the A-B-C of major causes of cardiovascular disease (CVD) in England.

It is estimated CVD costs the wider economy £15.8 billion per year and causes 1 in 4 deaths.

It’s well known that many people are living with undiagnosed CVD or if diagnosed it is badly managed. These conditions often carry no symptoms meaning millions of people are unaware they are at risk and in need of treatment. It is believed that over 5 million are currently living with undiagnosed high blood pressure in England alone.

Today CVD causes 1 in 4 deaths in England or 1 every 4 minutes. In 2016 heart disease was the leading cause of death for men and the second biggest for women after dementia.

The NHS long term plan (NHSLTP) has the ambition to prevent 150,000 cases of Strokes, heart attacks and dementia over the next 10 years.

The old adage prevention is better than cure is the mantra and Health Secretary Matt Hancock is on record as saying

“Prevention is at the heart of our vision for improving the health of the nation, empowering people to stay healthy, not just treating them when they’re ill. Millions of people are needlessly at risk of heart attacks or strokes when it could be prevented. So I want to help more people take the time out to protect their future health and get checked.”

These are the ambitions for Atrial Fibrillation (AFib) and Blood Pressure.

Atrial Fibrillation

85% of the expected number of people with AF are detected by 2029
90% of people with AF who are known to be at high risk of stroke to be adequately anti-coagulated by 2029.

Blood Pressure

80% of the expected number of people with high BP are diagnosed by 2029
80% of the total number of people diagnosed with high BP are treated to target as per NICE guidelines by 2029

How do we achieve these objectives when Primary Care is already overstretched?

By using the NHS Health Check to support early diagnosis and management can encourage people to make healthy life style choices such as eating well, reducing alcohol and taking more exercise is one approach.

New technology and new approaches can also help.

I’ve written previously on this Blog about opportunistic screening in different settings including community settings. Pharmacists for instance are already using new technologies and products like the AliveCor Kardia Mobile ECG and A&D UA-767 S blood pressure monitor with AFib + technology to actively and opportunistically identify at risk patients.

Already used extensively throughout the NHS the Kardia Mobile ECG monitor is clinically validated and automatically detects AFib in 30 seconds. Its quick uses a smartphone App and costs under £99.

Published today the CVD goals and ambitions Public Health England and NHS England hope to achieve by 2029 should be welcomed. If made a reality, the prospects of millions of at risk people will be transformed for the good.

The missing 5.5 million with undiagnosed high BP.

A new resource – Blood Pressure – How Can We Do Better? – has just been launched and can be accessed at the British Heart Foundation website.

It has been developed by stakeholders including GPs, nurses and pharmacists working with organizations including NHS England, Public Health England, the British Heart Foundation, the Stroke Association and the Royal College of General Practitioners.

It is well known that high blood pressure affects one in four adults in England and is one of the leading causes of premature death in England. At least half of all heart attacks and strokes are associated with high blood pressure.

Treatment thankfully is very effective – for every 10mmHg reduction in blood pressure, the risk of a life changing heart attack or stroke is reduced by 20%.

What’s the challenge?

Finding undiagnosed hypertensives, around 25000 in the average CCG or 5.5 million in England, unaware of their increased risk and not receiving treatment is the challenge. It’s also worth remembering that of those diagnosed with high BP, one in three, are not treated to target.

GP Practices and Clinical Commissioning Groups (CCGS) need to do things differently to improve detection and increase opportunistic screening.

What practical steps should GP Practices take?

Think BP! Whether in routine consultations, or in nurse led clinics, like COPD, asthma and diabetes. Encourage opportunistic screening and ensure identification of poor BP control is the responsibility of all clinicians.

Think BP! In accordance with NICE CG127 guideline on Hypertension always offer ambulatory 24 hour blood pressure monitoring or when appropriate home blood pressure monitoring to confirm a diagnosis of high BP. Ensure BP equipment is serviced and calibrated regularly by reputable third parties with experience of the devices you use.

Think BP! Use clinically validated waiting room self-test BP monitors like the A&D Medical TM-2657P to make it easier to collect BP data, save appointment time and empower patients to actively use this equipment.

Think BP! Advise patients of the option to buy clinically validated low cost blood pressure monitors like the UA-767S from established suppliers so they can monitor their blood pressure at home.

There is also a role for Clinical Commissioning Groups (CCGs) who need to do things differently to improve detection, support GP Practices and increase opportunistic screening.

They can use the BHF website to see how many people in their CCG have undiagnosed high blood pressure.

How do we diagnose more patients with high blood pressure?

Time pressured consultations and other clinical priorities are a factor and simply mean in many instances there isn’t enough time to record a blood pressure. The answer is the wider adoption of technology like the A&D Medical TM-2657P waiting room BP monitor and doing things differently.

How does it work?

Patient self-measurement of blood pressure using A&D waiting room blood pressure monitors have been used in the UK since PMS Instruments introduced them in 2002. They are an established part of many GP Practices hypertension diagnosis and management pathways. Put simply the patient records their blood pressure which is printed on a paper slip. This is then shown to the clinician during the consultation. The readings can be input to the patient’s clinical record.

What does the future for detection and management of high BP hold?

With no extra capacity at present the situation won’t be improved by GP’s working harder. It may be improved by doing things differently, changing the system and the wider adoption of new technology. If you are a GP Practice, CCG or GP Federation and want to find out more about the latest BP measuring technology contact me.