Uncontrolled blood pressure in Australia: a call to action

In reply: We have recently published a call to action to improve uncontrolled blood pressure in Australia.1 In this call we recognise that raised blood pressure/hypertension affects one‐third of adults in the country, and only a staggeringly low 32% of those with high blood pressure have it under control.2 Although we did not distinguish between high risk groups in our call to action, we strongly support the Letter to the Editor by Bailie and colleagues3 pointing out that Aboriginal and Torres Strait Islander (hereafter referred to respectfully as Indigenous) people have a higher prevalence of raised blood pressure than non‐Indigenous Australians in every age group. It is thus no surprise that Indigenous Australians are disproportionately affected by cardiovascular disease as a leading cause of death. There are many reasons for this disparity, with one of the gaps highlighted by Bailie and colleagues being clinician treatment inertia in these communities. This refers to the situation where blood pressure‐lowering treatment is not initiated or intensified despite uncontrolled blood pressure, and has been proven to play a significant role in the low rate of hypertension control seen in many countries.4

We have several tools available to prevent hypertension, but also to improve detection of elevated blood pressure, treatment (inertia), and control in primary care. These may include the MAP actions developed in the United States to Measure (blood pressure) Accurately, Act Rapidly and Partner with Patients,5 shown to be effective in improving blood pressure control in underserved patients. System‐wide actions may include population‐based preventive strategies that will address several components throughout the life course (eg, reduced salt, sugar and alcohol intake and increasing fruit and vegetable intake).1 Such strategies would address raised blood pressure in all of Australia, including Indigenous people, but will require specific actions for successful implementation and uptake in these communities. At the same time, we need to acknowledge the importance of regularly collected health data from the general population, but specifically from Indigenous populations, and we strongly encourage funding to address these gaps to improve the future detection, treatment and control of raised blood pressure across the board.