More Than Half of English Adults With High Blood Pressure Do Not Know They Have It, a Study of 1.4 Million Finds

Researchers from Oxford Population Health analysed clinic blood pressure readings from 1.4 million adults enrolled in Our Future Health, the UK's largest health research programme, between 2022 and 2025, and found that 37 per cent had hypertension, and that 59 per cent of those, an estimated 1.3 million people, had never been diagnosed. The study, published in BMJ Public Health, is summarised in StudyFinds' write-up and in a parallel report from Joe, both dated this week.

Who is most affected

The condition, sometimes called the "silent killer" because it typically produces no symptoms while quietly raising the risk of heart attack, stroke and kidney disease, was more common in men than women, affecting 42 per cent of men against 29 per cent of women in the sample, and became steadily more common with age. A further summary carried by Inkl notes the researchers drew on real clinic measurements rather than self-reported survey data, which is part of why the undiagnosed share is considered a more reliable estimate than earlier survey-based figures.

Diagnosis is only half the problem

Among the people in the study who had already been diagnosed and were being treated by a doctor, only about half had their blood pressure adequately controlled, meaning the true scale of unmanaged hypertension in England is larger than the undiagnosed figure alone suggests: some patients do not know they have the condition, and a further large group knows and is being treated but is still not at a safe reading. The researchers, writing in BMJ Public Health, concluded that England's current approach to finding and managing high blood pressure "is not fit for purpose", language unusually blunt for a peer-reviewed paper and a direct challenge to how GP practices currently screen for the condition.

What the researchers are recommending

The paper's authors are not proposing a single new drug or device; the intervention they are calling for is systemic, more consistent opportunistic blood pressure checks, better follow-up on borderline readings and closer monitoring of patients already on treatment, none of which requires new medical technology so much as a change in how existing GP contact points are used. Because the sample comes from Our Future Health's own volunteer cohort rather than a random national sample, the true national undiagnosed figure could differ somewhat from 1.3 million, but the direction of the finding, that a large share of a very large sample either does not know it has hypertension or is not adequately treated for it, is consistent with decades of UK blood pressure research and gives it added weight rather than casting doubt on it.