The Core20PLUS5 Hypertension Research Project
Cardiovascular disease remains the leading cause of premature death in England, yet much of it is preventable. Richard's doctoral research is evaluating whether clinically supervised exercise can provide a more effective, scalable approach to preventing heart attacks and strokes in adults over 60 with hypertension, while reducing health inequalities and easing pressure on the NHS
For many years, the challenge was a knowledge gap—we simply did not know whether exercise could effectively reduce blood pressure.
Decades of high-quality research have now answered that question. Exercise is one of the most effective non-pharmacological treatments for hypertension and is recommended by national and international guidelines. The problem today is no longer a lack of evidence; it is a lack of implementation.
Despite overwhelming scientific support, structured exercise is rarely embedded within NHS hypertension pathways because it requires upfront investment in specialist services.
This creates a costly paradox: we continue to fund the long-term consequences of poorly controlled hypertension while failing to invest in interventions that could prevent them.
​Clinical Exercise Physiologists are highly trained healthcare professionals who specialise in using exercise as medicine for people with long-term health conditions. They combine expertise in cardiovascular physiology, exercise prescription, behaviour change and chronic disease management to deliver safe, personalised, evidence-based programmes that improve health and reduce risk.
Despite strong scientific evidence and national guideline recommendations, they remain largely absent from routine NHS hypertension pathways, leaving a significant gap between what research shows is effective and what patients actually receive.
This research aims to bridge that implementation gap by generating the evidence needed to integrate Clinical Exercise Physiologists into NHS hypertension care.
By evaluating clinical effectiveness, feasibility and real-world implementation, the project will help determine how this model can be delivered at scale—improving blood pressure control, reducing health inequalities, preventing cardiovascular complications, and creating a more sustainable NHS for future generations.
Targeting the Core20PLUS5 population is essential because it focuses on those at greatest risk of hypertension and its devastating consequences, while also being the least likely to access effective lifestyle support.
These communities experience higher rates of heart attack, stroke, kidney disease and premature death, yet exercise remains underused despite strong clinical evidence.
By evaluating how Clinical Exercise Physiologists can deliver exercise within NHS pathways for Core20PLUS5 communities, this research aims to reduce health inequalities, improve outcomes where the need is greatest, and create a scalable model that could improve population health while reducing long-term pressure on the NHS and wider economy.
Every donation will be invested directly into delivering high-quality, impactful research.
Donations will fund specialist Clinical Exercise Physiologist-led exercise programmes for participants, comprehensive clinical assessments, blood pressure monitoring equipment, exercise and safety equipment, participant support, data collection and statistical analysis, community engagement, research governance, ethics, dissemination and publication of the findings.
It will also support the essential infrastructure required to deliver a rigorous PhD study, ensuring the research meets the highest scientific and clinical standards. Most importantly, your support will help generate the implementation evidence needed to integrate Clinical Exercise Physiologists into NHS hypertension pathways, making evidence-based exercise accessible to the people who need it most.
Every pound invested today has the potential to improve lives, reduce health inequalities, prevent heart attacks, strokes and kidney disease, and deliver lasting savings for the NHS and society.
Puja Patel
Head of Healthcare Scientist Workforce
NHS Hampshire & IOW
"This proposal addresses an important and timely gap in the translation of exercise-based interventions into routine NHS practice"
"The focus on prevention, health inequalities through the Core20PLUS framework and community-based delivery aligns strongly with current NHS strategic priorities."
"Richard's work demonstrates a clear understanding of both the clinical and system challenges and his proposal has the potential to generate meaningful evidence to inform future service development."​
Dr Andy Galbraith
Associate Professor Exercise Physiology
University of East London
"The proposal addresses and important area of research within cardiovascular prevention and health services delivery"
"In terms of potential impact, the study could inform future service development and workforce models."
"Overall this is a thoughtful and relevant proposal that balances ambition with practical considerations. It has the potential to make a useful contribution to both academic understanding and applied healthcare practice"​
