Setting the UK research priorities for hypertension using a modified Delphi approach: a British and Irish Hypertension Society Initiative with Support from the British Heart Foundation Clinical Research Collaborative

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BACKGROUND: Hypertension is the leading modifiable risk factor for cardiovascular disease in the UK and Ireland, yet significant implementation gaps and health inequalities in hypertension management persist. The British and Irish Hypertension Society (BIHS), in collaboration with the British Heart Foundation Clinical Research Collaborative (BHF-CRC), undertook the first national initiative to identify priority areas for future hypertension research. METHODS: A modified Delphi approach, informed by James Lind Alliance methodology, was used to gather and rank research questions. The process involved clinicians, allied health professionals, researchers, and patients, supported by a multidisciplinary steering group. Questions were refined through iterative surveys and a final consensus workshop. RESULTS: From an initial list of 66 research questions, 38 were shortlisted for the prioritisation exercise, which resulted in a Top 10 list of national hypertension research priorities.Key themes included digital and remote monitoring, reducing health inequalities, supporting treatment adherence, and determining the role of blood pressure management in preventing dementia, frailty-related outcomes, and kidney disease. Priorities also addressed optimal treatment targets, home versus clinic monitoring, and the impact of new obesity therapies on cardiovascular health. CONCLUSION: This is the first structured, consensus-driven national initiative to recommend hypertension research priorities in the UK and Ireland. The resulting Top 10 reflect a shift towards person-centred research that emphasises implementation, digital innovation, and equity, alongside pharmacological and mechanistic studies. These priorities provide a roadmap for funders, policymakers, and researchers to address unmet clinical needs and improve outcomes for people living with hypertension.

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