Few public health issues in the UK are as significant as the problem of hypertension, or high blood pressure (BP). The figures are striking – more than 14 million adults have hypertension, and as many as five million are thought to be undiagnosed (British Heart Foundation (BHF), 2019).

Hypertension contributes to around half of all heart attacks and strokes in the UK (BHF, 2019), and is a risk factor for open angle glaucoma (see College Clinical Management Guideline). It is also a risk factor for vision loss from hypertensive retinopathy (RNIB, 2016). Vanessa Smith, Senior Cardiac Nurse at the British Heart Foundation (BHF), says: “Detecting more cases of undiagnosed hypertension will have a significant health impact.”

In 2014, the Dudley local optical committee (LOC) joined forces with Public Health Dudley to develop the first Healthy Living Optical Practice (HLOP) in England. Community pharmacies throughout the UK had already taken steps to offer health promotion services and check-ups, but in Dudley, the idea emerged of local optical practices taking on new services carried out by trained optical practice staff. These services included smoking cessation services, alcohol use screening, glucose and cholesterol testing, and BP monitoring.