Professor Bryan Williams is the chair of medicine at University College London (UCL) and the president of the International Society of Hypertension. We spoke to him about his career developing ways to prevent and treat hypertension and the role virtual healthcare plays in doing this.
"I became interested in hypertension when I was quite young," Professor Williams shared. "As a young doctor, I worked in a kidney unit and saw people die because of high blood pressure. It shocked me because so many people with hypertension don't realise it, and it's easy to treat successfully”.
He went on to share, "I've been fortunate that I've been able to get to a position where I've been able to influence policy and treatment. For example, I chaired the development of both the NICE and European guidelines for hypertension. I've also done a lot of research which has provided evidence for developing treatments and practice guidance.’
When asked about the biggest challenges in managing hypertension, Professor Williams pointed to the low detection, treatment, and control rates. "Hypertension is the most common cause of premature death in the world. It accounts for about 10 million deaths yearly, even though it's so easy to treat. The problem is detecting it."
"It doesn't cause any symptoms, so people only know they have high blood pressure if it gets routinely measured by a doctor or someone else in a healthcare setting."
He went on to discuss what he calls "The Rule of Halves," explaining that "about half the people in the world with hypertension are actually diagnosed. Then only half of those people are treated, and only half again get their blood pressure under control. So we end up with only 25% of people with hypertension getting it under control."
In addition to the issue of detection and treatment, Professor Williams also emphasised the need for long-term engagement in hypertension management.
"Even if someone gets their blood pressure under control, you've got to keep them engaged throughout their lifetime. We don't want healthcare to be intrusive, so we want to manage hypertension effectively but be as invasively as possible."
When asked about the potential role of virtual healthcare in addressing these challenges, Professor Williams was enthusiastic. "I think virtual healthcare is the answer here!"
"We know that GP practices are under unprecedented pressure at the moment. Patients struggle to access face-to-face appointments and get the kind of dialogue they'd like from their doctors. Managing conditions like high blood pressure takes up more than 10% of all appointments - it shouldn't take up any of these"
He went on to highlight the benefits of virtual clinics for both healthcare providers and patients. "Organisations like Suvera are the future. Moving chronic disease management to a virtual environment would give GPs time to focus on more acute and serious problems. Another benefit is their approach to science and data. There are loads of guidelines for hypertension which is a good thing, but it can sometimes be challenging.”
“It's hard as a doctor at the coal face to take all this information in and ensure your practice is up to date. It doesn't happen quickly because you've got some much going on at the same time. Virtual clinics that are structured around adapting as best practice changes and new data comes in. They can adjust quickly, meaning patients get the best treatment."
Professor Williams also highlighted the benefits for patients, saying "patients would really benefit from virtual primary care. The idea of people taking time off work to see a doctor to check their blood pressure is crazy. We can do it in a much more effective and straightforward way."
"Patients can take their own measurements, engage with their treatment, and get feedback from a clinician swiftly. This is great for chronic health management as we know from research this leads to much better patient outcomes."
