Bronwen Morgan-Jones explains why tackling high blood pressure is needed as part of a wider preventative healthcare agenda to reduce cardiovascular disease in Wales.
Around 340,000 people in Wales are living with cardiovascular disease (CVD), causing an average of 27 deaths each day.
CVD is the general term used for conditions which affect your heart or circulation, such as heart attack and stroke. Cardiovascular diseases are caused by risk factors: habits or conditions which increase your chance of CVD and include smoking, diabetes and high blood pressure. Many risk factors can be controlled, treated and modified, including high blood pressure.
The annual number of deaths from CVD in the UK has fallen by nearly half since the 1960s. However, for the first time in decades, progress has now reversed, and we have seen an increase in the number of cardiovascular deaths in Wales. In 2023, Wales had the highest working-age cardiovascular death rate of the UK’s four nations.
High blood pressure is one of the most significant, and preventable, CVD risk factors in Wales. Although the condition rarely presents any symptoms, around 50% of heart attacks and strokes are linked with high blood pressure. However, as many as 220,000 adults with high blood pressure remain undiagnosed in Wales. Therefore, improving the diagnosis and treatment of the condition could help prevent a significant number of life-threatening cardiovascular events, reduce emergency admissions and save vital NHS Wales capacity and funds.
In 2023, Wales had the highest working-age cardiovascular death rate of the UK’s four nations.
Today, British Heart Foundation (BHF) Cymru are launching a report – Tackling High Blood Pressure: Wales’ Silent Killer – outlining the impact of high blood pressure, the challenges to detecting, diagnosing and managing the condition, and recommendations to ensure everyone in Wales is better supported to manage their blood pressure and heart health.
The launch of the report coincides with the recent publication of a CVD Prevention Plan by Public Health Wales, reflecting the shift towards preventative healthcare within Welsh Government. BHF Cymru welcome these developments and continue to campaign for Welsh Government to resource and fund the delivery of the Plan; this opportunity must be used to drive forward progress in preventative healthcare and continue building a healthier environment in Wales.
The causes of high blood pressure in Wales
An estimated 750,000 adults in Wales have high blood pressure. Anyone, at any age, can develop high blood pressure and there is no singular cause for the condition. However, many people develop it because of their diet, lifestyle or medical condition. High blood pressure can often be lowered through lifestyle changes including stopping smoking, reducing the amount of salt in your diet, increasing physical activity, and reducing alcohol intake.
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The ability to live a healthy and active lifestyle is, however, often impacted by an individual’s environment. In Wales, deprivation continues to be linked to higher smoking rates, lower physical activity and higher CVD death rates; in particular, smoking rates are almost three times higher in the most deprived areas of Wales, compared to the least deprived. Poverty rates in Wales remain at around 22%, with little progress being made in the past 20 years, meaning deprivation continues to lead to health inequalities. Reducing poverty in Wales would help to create a healthier environment for future generations, help prevent CVD, and reduce pressure on the NHS.
What are the challenges to controlling high blood pressure?
Alongside health inequalities, BHF Cymru have identified four other key challenges to controlling high blood pressure in Wales. These are:
- Limited public awareness around the severity of high blood pressure
- Health system pressures within primary care settings
- Lack of quality data which allows us to understand the scale of the challenge
- Limited adherence to medication which controls high blood pressure
Further information on these challenges can be found in the report.
To tackle these challenges, BHF Cymru’s report identifies four priority areas which Welsh Government must focus on to ensure more equitable and sustainable support for people to manage their blood pressure, and live healthier lives.
- Delivering an all-Wales approach to CVD prevention
Welsh Government must commit to a fully funded, nation-wide CVD prevention plan. This must include a focus on tackling health inequalities if we are to see lasting improvement to the heart health of Wales.
Although the condition rarely presents any symptoms, around 50% of heart attacks and strokes are linked with high blood pressure.
Scotland’s CVD Proactive Care and Prevention Programme provides an example of what can be achieved with cross-sector collaboration, dedicated leadership and political will. In April 2025, Scottish Government committed £10.5 million to an ‘enhanced service’ within General Practice for cardiovascular conditions and risk factors, including high blood pressure, obesity and smoking. This service will focus on providing equitable support across the country to identify and treat those at risk of developing CVD and reducing the future threat of serious illness.
BHF Cymru urge Welsh Government to make a similar commitment to fund and deliver a CVD prevention plan for Wales.
- Better awareness, understanding and empowerment
Despite the potentially serious consequences of leaving high blood pressure undiagnosed and untreated, there remains limited public awareness of the condition. A widespread public awareness campaign on high blood pressure, and CVD in general, would address this challenge and empower the public to engage in their healthcare. This could be delivered alongside other public awareness campaigns such as the 2023 Act F.A.S.T stroke campaign.
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- Transforming systems of care
Healthcare must be accessible for everyone in Wales to improve the diagnosis and management of high blood pressure and reduce health inequalities.
Testing blood pressure in a variety of community locations, such as libraries, and at-home blood pressure monitoring are effective methods to achieve this, while also reducing pressures on GPs. However, such an initiative must be planned and delivered in collaboration with a variety of healthcare professionals who are sufficiently equipped and supported. At-home monitoring can also encourage greater patient involvement in their healthcare, improve public understanding of blood pressure and increase adherence to prescribed medication.
- Improving data collection and availability
Lastly, Welsh Government must commit to improving the collection of quality data on high blood pressure, which must be made available to clinicians and policymakers. Without this, we cannot fully understand the scale of the problem or target resources to areas most in need.
Welsh Government must commit to a fully funded, nation-wide CVD prevention plan.
Learn more about BHF Cymru’s recommended actions to tackle high blood pressure in Wales in the report.
Conclusion
Tackling high blood pressure in Wales must be a priority for the next Welsh Government if they want to tackle the challenges of cardiovascular disease and build a healthier, more equitable nation.
Together, we can keep Wales’ hearts beating healthier for longer.
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