High Blood Pressure: policy context
Policy pertaining specifically to high blood pressure or hypertension is limited in Scotland, with most policy instead focusing on its role as a risk factor for the development of heart disease. High blood pressure is identified as a priority within the Heart Disease Action Plan, 2021, which recommends the wider use of blood pressure monitoring in community settings and self-monitoring at home. This includes a focus on improving tele-monitoring of blood pressure through the "Scale-up BP" initiative, which is part of the Technology Enabled Care (TEC) programme and is funded by the Scottish government. The final evaluation of this initiative reports positive outcomes in controlling hypertension.
A 2024 cross-party inquiry into the implementation of the Heart Disease Action Plan, funded by the British Heart Foundation (BHF), found that action on the recommendations described above had stalled in the wake of the COVID-19 pandemic. This was attributed to pressure on primary care services, and a lack of data which has limited the ability to undertake quality improvement benchmarking.
Similarly, the 2019 cross-party report Beating High Blood Pressure: Scotland’s Silent Killer, funded by the BHF, identified the need for a task force to implement various recommendations aimed at tackling modifiable risk factors, increasing early detection and broadening participation in self-monitoring of hypertension.
There is specific guidance on the clinical management of high blood pressure in Scotland in the form of the Scottish Intercollegiate Guideline Network (SIGN) guideline 149 (2017) - Risk estimation and the prevention of cardiovascular disease.
The National Institute for Health and Care Excellence (NICE) provides UK-wide clinical guidelines on the diagnosis and management of high blood pressure (NG136; updated November 2023) and on the prevention of cardiovascular disease (NG238; updated December 2023). The 2014 Joint British Societies (JBS3) report includes a risk score to guide the treatment of high blood pressure.
High Blood Pressure was included in the Quality and Outcome Framework of the 2004 General Medical Services contract.
