The control of blood pressure

Hypertension is the leading risk factor for death and disability worldwide. Although there is reliable evidence on the association between high blood pressure and ischemic heart disease and stroke, the relationship between high blood pressure and the risk of other cardiovascular events is less well understood, and is a core focus of our research and international collaborations.

In particular, there is much uncertainty around the role of high blood pressure treatment in the context of atrial fibrillation, multimorbidity and heart failure. We are looking into how effective treatment for high blood pressure is in people with these conditions, with major implications for both patients and healthcare professionals.

Researchers are also exploring links between the use of anti-hypertensive drugs and the development of type 2 diabetes, by employing novel genetic modelling methods and drawing on large datasets from the UK population.

Our work with big data also includes leading the Blood Pressure Lowering Treatment Trialists’ Collaboration (BPLTTC), first established in 1995. This collaboration aims to pool all available data from large blood pressure lowering trials in order to look at the effects of such interventions in very specific groups (e.g. by body mass index or history of cardiovascular disease), and to observe associations between exposure and outcomes, made possible only through the statistical strength afforded by large volumes of data. The current cycle contains data from at least 50 trials involving over 350,000 participants, and is set to grow to include data from over half a million people.

This research has the potential to generate high-quality evidence to inform hypertension guidelines and change clinical practice in terms of patterns of care and health service delivery. Ultimately, our hope is that people will receive safer, more effective, and better quality care.