New TILDA study shows widespread under-diagnosis and under-treatment of high blood pressure in over 50s
Posted on 15 January 2026
New research from TILDA reveals substantial and persistent gaps in the diagnosis and management of high blood pressure among people aged 50 and over in Ireland, despite clear clinical guidelines and effective treatments.
Published in Open Heart, the study examines adherence to European Society of Cardiology (ESC) hypertension guidelines over a 12-year period, using data from more than 8,000 TILDA participants.
High blood pressure remains poorly controlled
High blood pressure, or hypertension, is a major risk factor for cardiovascular disease, stroke, dementia, and chronic kidney disease. Often symptomless, it can go undetected for many years.
The study found that at the most recent data collection:
- 62% of adults aged 50+ with high blood pressure were not appropriately managed, meaning they were undiagnosed, untreated, or treated but not controlled
- This equates to approximately 445,000 people nationwide
- When the latest 2024 ESC blood pressure target of <130/80 mmHg is applied, the proportion not optimally managed rises to 77%
Importantly, the findings show that this is not a new problem. Poor detection and control of high blood pressure has persisted across more than a decade of follow-up.
Key findings from the study
- Hypertension prevalence increased from 63% to 71% over 12 years
- Only 56% of people with hypertension were aware they had the condition
- While 71% were taking medication, treatment intensity was often suboptimal
- Just 33% of treated individuals achieved the guideline-recommended target of <130/80 mmHg
- 40% of adults had elevated blood pressure and 71% of this group were already at high cardiovascular risk
Encouragingly, higher-risk groups, including people aged 85 and over, those with frailty, and people with chronic kidney disease, were more likely to receive guideline-recommended treatment, demonstrating that targeted care can be effective.
“A significant unmet need in Ireland”
The study was led by Dr Caoimhe McGarvey, Research Fellow at TILDA and Specialist Registrar in Geriatric Medicine at St James’s Hospital Dublin.
“High blood pressure is a common and treatable condition. However, when left untreated it can cause heart disease, kidney disease, stroke and dementia. This study highlights a significant unmet need in the management of high blood pressure in Ireland. Addressing this need systematically has the potential to dramatically improve health outcomes for older adults across the country.”
Professor Donal Sexton, Consultant Nephrologist and Associate Professor at Trinity College Dublin, added:
“This study demonstrates the unique ability of TILDA to assess how well we are performing as a nation in managing modifiable risk factors for cardiovascular disease, chronic kidney disease and premature death.”
A simple public health message
Regius Professor Rose Anne Kenny, Principal Investigator of TILDA and Professor of Medical Gerontology at Trinity College Dublin, emphasised the importance of early detection:, said:
“If you are 40 years or over, get your blood pressure checked. It’s quick, painless, and can make a life-changing difference.".
TILDA has highlighted gaps in blood pressure detection and control for more than a decade. What makes this study particularly powerful is the maturity of the dataset, following the same individuals over 12 years, providing Ireland with a unique national resource for understanding how health changes with age and how well health systems respond.
Supporting healthier ageing in Ireland
This research aligns closely with HSE and Department of Health priorities, which emphasise early detection and effective management of chronic conditions to support healthy ageing and reduce avoidable illness.
High blood pressure is easy to check and often straightforward to manage once identified. Adults are encouraged to have their blood pressure checked regularly by their GP or local pharmacist, particularly as they get older or if they have other health conditions.
You can read the study: Adherence to the European Society of Cardiology hypertension guidelines over 12 years of follow-up in the Irish populationat the following link: https://openheart.bmj.com/content/12/2/e003744