PopulationsHumans

Over half of adult hypertension in England goes undetected

In 1.4 million adults, 37.2% had hypertension, 58.8% of cases were undetected, and 50.2% of treated individuals lacked blood pressure control.

Figure 1. Prevalence of hypertension by age and sex, defined using WHO criteria, with crude prevalence for all age groups by sex denoted as ‘All’ and age-standardised prevalence as ‘All (std)’. — Figure 1. Prevalence of hypertension by age and sex, defined using WHO criteria, with crude prevalence for all age groups by sex denoted as ‘All’ and age-standardised…Prevalence of hypertension by age and sex, defined using WHO criteria, with crude prevalence for all age groups by sex denoted as ‘All’ and age-standardised prevalence as ‘All (std)’.Liu et al.

BMJ Public Health4 Oct 2026, 07:24 BST

In an analysis of 1.4 million adults aged 18 and older in England from the Our Future Health study, 37.2% had hypertension based on clinic measurements or medication use. Age-standardised prevalence was higher in men than women at 41.9% versus 28.6%. Prevalence increased steeply across age groups, rising from 23% in men and 10% in women aged 18–39 to 73% in men and 69% in women aged 80 and older. Despite the high burden, 58.8% of participants with hypertension were undetected. Older age, male sex, higher body mass index, and personal history of cardiovascular disease or diabetes were linked to higher odds of detection. Among participants taking antihypertensive medication, 50.2% did not achieve blood pressure control, defined as systolic pressure below 140 mm Hg and diastolic pressure below 90 mm Hg.

Why it matters

Hypertension prevalence increases markedly with age, reaching 73% in men and 69% in women aged 80 and older. The large proportions of undetected and uncontrolled cases suggest that elevated blood pressure remains substantially undertreated in older adults.

Caveats

The cross-sectional design relied on blood pressure measurements taken at a single study visit, which can misclassify transient elevations as hypertension. Furthermore, medical history and medication use were self-reported, and individuals reporting serious pre-existing health conditions were excluded from the primary analysis.