A series of practical resources to enable leaders and professionals with direct reach to communities and an established, trusted relationship, for example community leaders, social prescribing link workers and faith leaders, to support their communities to reduce their risk of becoming seriously ill from Covid-19

1. 1st October 2020
Part of the BHealthy webinar series
Long term conditions:
High Blood Pressure
Dr Alex Meyer (GP)
Dr Sajjad Sarwar (GP)

2. Agenda
12:30 – 12:35
Welcome, introductions and housekeeping -
Stacey Gunther
Public Health, Birmingham City Council
12:35 – 13:15
Speakers
Dr Alex Meyer (GP)
Dr Sajjad Sarwar (GP)
13:15 – 13:30
Q&A and Discussion –
Dr Alex Meyer (GP)
Dr Sajjad Sarwar (GP)

3. HOUSEKEEPING
Please stay muted and turn your cameras off during this webinar.
Please turn off any VPNs (e.g. Netmotion, Cisco, etc.) to save bandwidth.
Please use the chat function to ask questions for the Q&A or you can email
your questions to healthybrum@birmingham.gov.uk
To make this webinar available to those that are unable to join us, today’s
webinar will be recorded. The recording, with both audio and visual will be
shared next week via email and online platforms.

4. BHealthy
A series of practical resources
to enable leaders and
professionals with direct
reach to communities and
an established, trusted
relationship, for example
community leaders, social
prescribing link workers and
faith leaders, to support their
communities to reduce their
risk of becoming seriously ill
from Covid-19
Webinar bookings via:
https://www.birmingham.gov.uk/info/50238/wellbeing_during_the_coronavirus_covid-
19/2247/bhealthy

5. High Blood Pressure
1st October 2020

6. Welcome
Dr Alex Meyer
GP and Strategic Clinical
Lead for Cardiovascular
Disease & Stroke for
Birmingham & Solihull CCG.
Dr Saj Sarwar
GP and West Birmingham
Alliance Cardiovascular Lead.
Dr Meyer & Dr Sarwar

7. Dr Saj Sarwar
Why is high blood pressure important, especially during Covid-
19?
What are the health complications of high blood pressure?
Knowing your numbers
Signs and symptoms of high blood pressure
At risk groups (including BAME communities)
Dr Meyer & Dr Sarwar

8. Dr Alex Meyer
Treatment: Lifestyle changes
Pharmacological management
Dr Meyer & Dr Sarwar

9. Why is high blood pressure important
Dr Meyer & Dr Sarwar

10. Dr Meyer & Dr Sarwar

11. What are the health complications of high blood
pressure?
Dr Meyer & Dr Sarwar

12. Knowing your numbers
• Rule of thirds………
• 1/3 population has Hypertension, don’t know it
• 1/3 population with Hypertension, not on treatment
• 1/3 population on treatment, are on suboptimal treatment
Dr Meyer & Dr Sarwar

13. Stages of Hypertension
• Normal
–< 135/85mmHg = Normotensive
• Stage I Hypertension
–135/85 – 149/94
• Stage II Hypertension
–>150/95
• Severe Hypertension
–> 180/120mmHg
Dr Meyer & Dr Sarwar

14. Aetiology
• Essential- 95% of causes….unknown
• Secondary hypertension- 5%
Dr Meyer & Dr Sarwar

15. Signs and symptoms of high blood pressure
• High Blood Pressure contributes to Cardiovascular Disease (CVD)
• General term for conditions affecting the heart or blood vessels
• CVD includes all heart and circulatory diseases, including coronary heart
disease, angina, heart attack, congenital heart disease, hypertension, stroke and
vascular dementia.
• You are more at risk of having CVD if you have Atrial fibrillation (AF), high Blood
pressure, or high Cholesterol. These are known as the ‘high risk conditions’ ABC
• Often only get symptoms when damage has started……..
Dr Meyer & Dr Sarwar

16. NHS Long Term Plan
Dr Meyer & Dr Sarwar

17. NHS Long Term Plan
• identifies cardiovascular disease as a clinical priority and the single biggest
condition where lives can be saved by the NHS over the next 10 years
• sets the ambition for the NHS to help prevent over 150,000 heart attacks,
strokes and dementia cases over the next 10 years
• outlines how we, and partners in the voluntary and community sector and in
other national organisations will meet this ambition.
Dr Meyer & Dr Sarwar

18. CVD in deprived populations
CVD is responsible
for one in four
premature deaths in
the UK and accounts
for the largest gap in
health life
expectancy.
CVD affects around
seven million people
in the UK and is a
significant cause of
disability and death
Those in the most
deprived 10% of the
population are
almost twice as likely
to die as a result of
CVD, than those in
the least deprived
10% of the
population
You are more at risk
of CVD if you have
diabetes or a family
history of heart
disease, if you are a
smoker, or are from a
black, Asian, minority
ethnic
(BAME) background
Mental health
patients ; Life
expectancy is 15-20
years lower than the
general population.
People with SMI have
a 53% higher risk of
having CVD and 85%
higher risk of death
from CVD
Dr Meyer & Dr Sarwar

19. New Challenge…….
Dr Meyer & Dr Sarwar

20. COVID-19
Dr Meyer & Dr Sarwar

21. The study, published in the
European Heart Journal,
revealed how many patients
with high blood pressure
died compared to those
without.
It also showed that those
who were not taking their
medication were even more
at risk of death
Dr Meyer & Dr Sarwar

22. A study published by the
Centers for Disease Control
and Prevention of more than
72,000 patients in China
found six per cent of people
with high blood pressure
(one in 16.6 people) died.
This compared with 0.9 per
cent in people who did not
have a condition
Dr Meyer & Dr Sarwar

23. Dr Meyer & Dr Sarwar

24. Why BAME groups at greater risk?
Dr Meyer & Dr Sarwar

25. BAME and Cardiovascular Disease
https://doi.org/10.1371/journal.pone.0178945
Dr Meyer & Dr Sarwar

26. BAME – higher risk
Dr Meyer & Dr Sarwar

27. COVID -19
High blood pressure
Are people with high blood pressure at higher risk for severe COVID-19
Illness?
Yes. Having hypertension (high blood pressure) may increase your risk of severe
illness from COVID -19
How can I protect myself?
• Stay at home as much as possible.
• Take your medication for any underlying health conditions exactly as prescribed
• Make sure that you have at least a 30 day supply of your medicine.
• Call your healthcare provider if you feel sick
• Follow the advice of your healthcare provider
Dr Meyer & Dr Sarwar
Call the COVID-19 Hotline: 0800 029 999
Send “Hi” on Whatsapp to COVID-19 Connect: 0600123456
Visit the Website www.sacoronavirus.co.za

28. How to lower your Blood Pressure
Dr Meyer & Dr Sarwar

29. Diet
Dr Meyer & Dr Sarwar

30. Exercise
Dr Meyer & Dr Sarwar

31. Reduce Alcohol
Dr Meyer & Dr Sarwar

32. Weight Loss
Dr Meyer & Dr Sarwar

33. Reduce Caffeine
Dr Meyer & Dr Sarwar

34. Quit Smoking
Dr Meyer & Dr Sarwar

35. When are lifestyle changes not enough?
Severe hypertension (>180/120)
•>180/120mmHg
Secondary
hypertensionEvidence of
target organ damage
•when something else is
causing the high blood
pressure
Evidence of target organ
damage
•Heart, kidney or eye
disease, raised CVD risk
BP 150/95 or more
•Based on ABPM or HBPM
Dr Meyer & Dr Sarwar

36. What medications are used?
Dr Meyer & Dr Sarwar

37. How to take the medication
Take it at the same time each day
Try not to miss any doses
Read the patient information leaflet
If you have questions, ask your pharmacist or GP
Continue all the positive lifestyle changes you tried before
starting medication
Keep a list of your medication with you including doses –
perhaps have a photo of the boxes on your phone
Ask for advice before taking other medication that is not
prescribed
Attend for your check-ups – blood tests and other checks
help to keep you healthy
Know your numbers – if possible buy a BP machine, check
your blood pressure at home and write down the readings
Dr Meyer & Dr Sarwar

38. Take Home Messages
• Many people with high blood pressure don’t know they have it unless they
get checked
• High blood pressure is an important risk factor for heart disease, strokes,
and other serious conditions
• Patients with high blood pressure who get Covid-19 are likely to have a
more severe infection, particularly if they are not taking their medication
• High blood pressure is a very treatable condition – starting with lifestyle
and moving on to medication
• If you are diagnosed with high blood pressure, take it seriously, involve
your family, speak to a healthcare professional
Dr Meyer & Dr Sarwar

39. We hope you’ve enjoyed this talk – Here are some
Resources
• https://bihsoc.org/ British Hypertension Society
• https://www.nhs.uk/conditions/high-blood-pressure-hypertension/ NHS
Information on High Blood Pressure
• https://www.healthline.com/nutrition/dash-diet DASH diet
• https://www.nice.org.uk/guidance/ng136/informationforpublic NICE
Hypertension Guidelines 2019 – Information for the Public
Dr Meyer & Dr Sarwar

40. Useful Resources
 IMPORTANT: Coronavirus and heart conditions information:
• https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health
• https://www.bhf.org.uk/informationsupport/coronavirus-and-
you?gclid=CjwKCAjwqJ_1BRBZEiwAv73uwI8CsZiNvlpGuJUEyhKj9wxjr3n-
ro4sPZrP_6DhsylgtTPNW_JvixoCEvYQAvD_BwE&gclsrc=aw.ds#condition
 'What is high blood pressure?’ (scroll down for video)
• https://www.bhf.org.uk/informationsupport/risk-factors/high-blood-
 How to lower your blood pressure.
• http://www.bloodpressureuk.org/your-blood-pressure/how-to-lower-your-blood-pressure/
 Translated High blood pressure information:
• https://medlineplus.gov/languages/highbloodpressure.html
• http://www.bloodpressureuk.org/resources/publications/translated-blood-pressure-information/
 Information on free activities:
• https://theaws.co.uk/about-us/
 Reducing your risk for people of African and African-Caribbean background booklet:
• https://www.bhf.org.uk/informationsupport/publications/other-prevention/reducing-your-risk-african-and-

41. Participants Discussion – How can
you enable communities to have better self-
awareness of high blood pressure?

42. Dr Meyer & Dr Sarwar

43. KEEPING IN TOUCH
BHealthy handouts can be found on our website
https://www.birmingham.gov.uk/info/50238/wellbeing_during_the_coronavirus_covid-19/2247/bhealthy
The full list of BHealthy webinars
https://www.birmingham.gov.uk/info/50238/wellbeing_during_the_coronavirus_covid-19/2247/bhealthy/2
For support with BHealthy or general enquires email
healthybrum@birmingham.gov.uk
or for Covid enquires email
BCCCovid19@birmingham.gov.uk