High blood pressure is still one of the biggest causes of preventable illness and death in Australia, but many people with it are not diagnosed, not monitored properly, or not treated enough.
Key points:
1. Blood pressure checks in Australia are not done often enough.
Many people who likely have high blood pressure are never picked up. Even when blood pressure is checked, it is sometimes measured incorrectly.
2. Home and 24-hour monitors are better than quick clinic readings.
Measuring blood pressure at home or using a 24-hour monitor gives a much more accurate picture. It avoids “white coat” readings (high only at the clinic) and “masked” readings (normal at the clinic but high elsewhere). These methods pick up patterns that short clinic readings miss.
3. Australia’s guidelines are out of date.
New guidelines overseas recommend tighter blood pressure targets (usually below 130/80 mmHg). Australia has not updated its national guideline since 2016, so it does not match newer evidence.
4. Lower blood pressure targets are supported by strong research.
International studies show that aiming for lower blood pressure reduces heart attacks and strokes. Australia may move to these lower targets in its 2026 guideline, but doctors still need to consider older or frail patients individually.
5. Starting with two medications often works better than one.
For many people with readings above 140/90 mmHg, using two blood pressure medicines together from the start is more effective and faster than starting with just one. Single-pill combinations help people take medication more reliably.
6. Lifestyle changes still matter a lot.
Reducing salt, improving diet (such as the DASH diet), exercising more, drinking less alcohol, and quitting smoking all lower blood pressure and improve overall health.
7. Doctors should check for secondary causes, especially primary aldosteronism.
Some people have high blood pressure because of an underlying condition like primary aldosteronism. Many cases are missed because standard tests don’t pick it up. A recent Australian study found 14% of newly diagnosed patients had this condition.
8. A new Australian guideline in 2026 aims to improve detection and treatment.
The upcoming guideline should improve measurement standards, encourage combination medications, make better use of lifestyle programs, and promote digital tools to support care.