Millions of people in England are unaware they have high blood pressure, a condition described as a “silent killer” by researchers. The largest study of its kind reveals that 59% of individuals with hypertension are undiagnosed, increasing their risk of stroke, heart attack, and early death.
The Oxford University study, which analysed data from 1.4 million adults, also found that among those diagnosed and receiving medication from their GP, blood pressure is uncontrolled in 50% of cases. Researchers suggest that the current approach to detecting and treating high blood pressure in England is “not fit for purpose.”
The study, published in BMJ Public Health, used data from the Our Future Health programme, focusing on people enrolled between 2022 and 2025 with high blood pressure defined as 140/90 mmHg or higher. It calculated that over a third of adults (37%) had high blood pressure, with six in ten of these unaware of their condition.
Hypertension was found to be almost 50% more common in men than women (42% compared with 29% across all ages) and more prevalent in older individuals. While detection and control improved significantly in the 2000s, progress has reportedly plateaued since around 2011, with indications of worsening trends following the Covid-19 pandemic.
Wenyu Liu, lead author and medical statistician at Oxford Population Health, stated that the study highlights the prevalence of hypertension across demographics and underscores the need for population-wide prevention strategies alongside targeted treatment. Dr Iain Turnbull, a GP and clinical research fellow at Oxford Population Health, noted that it is not clear why 50% of patients on blood pressure-lowering drugs have uncontrolled hypertension, citing factors such as dose changes, other health conditions, and practical challenges with consistent medication.