Daily Archives: 21/11/2015

Under pressure

This was a new report on high blood pressure (hypertension) and drinking behaviours that Alcohol Policy UK shared in October.

under pressure‘Under pressure’ [pdf], a new report on alcohol and high blood pressure, makes a series of recommendations to address what are ‘two of the most common preventable health harms in the UK’. The report was developed by an expert group, initiated and supported by Lundbeck pharmaceutical.

The report says improvements in primary care for hypertension and alcohol misuse are required for better integrated screening, brief interventions, and treatment for both conditions, which would reduce the incidence of other cardiovascular diseases. Both alcohol misuse and hypertension affect around a quarter of adults, however four out of ten people with high blood pressure (BP) will be undiagnosed.

A series of recommendations are made including improving brief intervention (IBA) rates for those with both conditions in primary care, and raising awareness of the links. Currently under NICE guidelines, primary care has a responsibility to deliver IBA to those with high blood pressure as part of its QOF. However the report includes results of a survey which suggests low levels of IBA amongst patients with high BP:

“…even in this ‘at risk’ population, screening for alcohol problems is only done on an intermittent basis; the results of the GP survey … indicate that only about 1-in-5 people with hypertension are screened for harmful drinking”

The report also identifies issues relating to pathways for referral of alcohol treatment services and challenges within the new commissioning landscape. Recommendations within the report include a move to ‘joint commissioning for a holistic and integrated alcohol treatment service that reflects the patient pathway from prevention through to specialist services’. The development of networks for trainers and clinical leads to support skills and best practice are also suggested.

See here for an Alcohol Concern factsheet on alcohol and hypertension.

This is an excellent recommendation as checking someone’s blood pressure is part of the easy non-invasive screening process that should be done on all almost irrespective of why you are going to see your GP.  And it is the ‘canary in the coalmine’ indicator with drinking that may give away an issue even if the person is reluctant to share honestly how much they are actually drinking.