One of the reasons I love Christmas is Christmas dinner – I could probably eat an entire extended family’s worth of roast potatoes on the day if it wouldn’t get me exiled from the table because, as is my understanding, they’re most people’s favourite part of the whole affair, too. But it’s not just the crispy exterior that sounds like distant fireworks when you bite into it, or the pillowy interior that reminds you to have some patience after you bite into it and come away with first degree burns in your mouth – it’s the taste, which I’m sure we’d all be very disappointed at being greeted with if they weren’t salted enough.
Salt is incredible, it makes everything taste better, and makes even the saddest vegetables an enticing prospect. We need it to function, too, as it contains sodium which the most important electrolyte we use to make our muscles fire. Unfortunately, it’s not without its downsides – sodium is a vasoconstrictor, meaning that it tenses your blood vessels and makes them narrower, increasing your blood pressure. If you have a high sodium diet for too long, you might end up with hypertension.
Blood pressure is simply the amount of force with which blood pushes against the walls of your blood vessels. It’s measured with two different metrics – systolic blood pressure, which is the force exerted on your blood vessels as blood is pumped through your body, and diastolic blood pressure, which is the force exerted on your blood vessels between heartbeats as your heart refills with blood. The higher your blood pressure, the more stress your blood vessels experience as your heart beats. Persistent high blood pressure is known as hypertension, and can lead to a swathe of medical issues.
Consistent elevated stress on your blood vessels leads to them being less elastic. This decreases the amount of blood that can flow through them, and also makes it easier for fatty material to build up along the lining of your blood vessels, causing clots which can travel to your brain, cutting off blood flow, and causing a stroke. It also means that your heart has to work harder to pump blood around your body, causing it to become weaker over time, leading to heart failure. High blood pressure also damages the blood vessels in your kidneys and eyes, reducing their ability to function properly, leading to kidney disease or failure, or vision loss or blindness.
It is estimated that 30% of adults in England are living with hypertension, about half of which are untreated, with prevalence increasing greatly with age. The good news is that it’s incredibly easy to treat and can be managed with a variety of simple medicines which greatly reduce the likelihood of any downstream conditions or events occurring. The problem is that it’s a slow, silent, and insidious killer – it’s hard to tell innately what your blood pressure is, and it can increase unnoticed over time.
Because of how widespread hypertension is, how much cheaper and easier it is to treat at early stages, but also how it would go unnoticed in many cases without going out of your way to test it, hypertension case-finding has been singled out as one of five clinical areas of focus requiring accelerated improvement as part of the NHS Core20PLUS5 framework.
At Unity Insights, we’ve done a considerable amount of work evaluating technologies and services targeting hypertension management:
Metadvice is an AI-powered cardiovascular disease clinician support tool with the ability to risk-stratify patients and provide treatment recommendations.
Florence is an SMS-based hypertension surveillance tool which makes it easier for clinicians to manage hypertension medication optimisation and improves patient adherence to treatment