Hypertension

Hypertension is persistently raised blood pressure, diagnosed in England when a clinic reading of 140/90 mmHg or higher is confirmed by ambulatory or home monitoring averaging 135/85 mmHg or higher. It is the most common condition recorded in general practice, at 15.8% of registered patients in 2025/26, and a leading modifiable risk factor for cardiovascular disease.

Diagnosis and management

NICE guideline NG136, first published in 2019 and last updated in November 2023, sets the diagnostic thresholds and treatment targets used across the NHS. For adults under 80, the clinic target is below 140/90 mmHg; for those aged 80 and over, it is below 150/90 mmHg. The Quality and Outcomes Framework (QOF) rewards practices for the proportion of patients on their register who reach these targets.

A large share of cases goes undiagnosed: the Office for National Statistics estimated that around 4.2 million adults in England had undiagnosed hypertension, based on survey data from 2015 to 2019. Detection runs through several routes:

• general practice, including opportunistic checks and QOF-incentivised recording
• the NHS Health Check, which local authorities must offer every five years to adults aged 40 to 74 without existing cardiovascular disease
• the community pharmacy Hypertension Case-Finding Service, running since October 2021, with a revised specification in force from 3 September 2026

National targets

The CVDPREVENT national audit found that 70.3% of patients with hypertension were treated to target in March 2025, short of the 80% ambition in 2024/25 planning guidance. The Cardiovascular Disease Modern Service Framework, published by the Department of Health and Social Care and NHS England in July 2026, aims to reduce deaths from heart disease and stroke in people under 75 by 25% within 10 years. For people with hypertension but no cardiovascular disease, it sets a goal of 75% treated to target within three years and 85% within 10 years. The 2026/27 NHS Oversight Framework also gives each Integrated Care Board a numeric target for hypertension managed to NICE thresholds.

Relevance to pharma and medtech

With national and ICB-level targets now in place, attention is on finding undiagnosed patients and improving control among those already diagnosed. That creates demand for blood pressure monitoring, ambulatory and home monitoring, digital tools, data-led case finding and support for primary care and pharmacy teams, as well as for medicines optimisation. ICB performance against CVDPREVENT data is a useful guide to where these gaps are largest.

‍