To exploit novel data analytic approaches to reduce premature death and disability from hypertension. The analysis of data from a customised App and system will safely enable the progressive introduction of automated clinical decision-making, for the precise control of drug dosing.

Hypertension (uncontrolled high blood pressure) is the leading preventable cause of premature death worldwide. Globally, 1.39bn people are estimated to have hypertension, and it caused ~10.7 million deaths in 2015\. It is projected to affect more than 1.5 billion people around the world by 2025\. In the UK ~30% of adults have hypertension, 9.5m have a diagnosis, and a further 5m people in England alone may have hypertension yet be unaware. In the current pandemic of COVID-19, people with hypertension are facing additional challenges in managing their condition as they are: \*socially isolating and not being able to meet with their GP/Healthcare Professional (HCP) with the same frequency \*reading stories in the press and scientific literature that indicate that a high percentage of patients with hypertension who contract COVID-19 have severe illness, are admitted to an intensive care unit, receive mechanical ventilation, or die. Being able to remotely monitor people with hypertension through use of a phone app that records daily BP readings, current treatment regimens and indicate any COVID-19 symptoms will address a current clinical need and enable medical management and patient engagement without the need for direct patient-HCP contact. We aim to update an already developed phone app designed for a hypertension focussed clinical study to include additional features for deployment in a new clinical trial in a COVID-19 setting. The trial will aim to demonstrate a "business as usual" approach to managing and monitoring a long term condition as well as collecting data help to answer questions that are of concern for the hypertension community namely: \*Does blood pressure drug use and/or level of blood pressure control affect risk of COVID-19 infection? \*Does blood pressure drug use and/or level of blood pressure control affect severity of COVID-19 illness/pneumonia? \*Do particular types of blood pressure medication affect risk of COVID-19 infection?

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"When a clinician treats a patient with a disease, a routine and common approach is to focus on one aspect of the treatment, for example, prescribing a drug. There may then be many weeks or months before review and it may be with a different clinician. It is hard for them to judge whether the first therapy has worked and they may switch to a different therapy. Some clinicians will take a holistic approach to therapy - they will also prescribe non-drug therapies, which could enhance the effectiveness of the drug. However, this approach is unusual, in part because of lack of time, but also because of problems integrating and synchronising drug and non-drug therapies (e.g. behavioural therapies). The ideal clinician would combine both drug and non-drug therapies, and then review the patient regularly to assess benefits, allowing them to 'close the loop', and modify the treatment, if required, to ensure the best outcome for the patient. This project enables Closed Loop Medicine (CLM) to work with clinical and technology specialists interested in optimising health through personalised medicine, critically with expertise in the drug, digital health and diagnostics spaces. We are starting with blood pressure because this is extremely common -- one in four adults in the UK has high blood pressure - but it is poorly controlled in a 1/3rd of these patients. This then leads to higher rates of heart attacks and strokes. More recent research has indicated that even better outcomes can be achieved by lowering blood pressure even more than that currently recommended. This would mean that 60% of current adults would need treating and the tighter blood pressure control would be even harder to achieve without causing side effects. By combining blood pressure measurement, drug and non-drug therapies in a closed-loop via a smartphone app we will demonstrate that we can optimise individual treatment for far more patients. The intent is to also empower patients to feel more in control of their treatment and aware of the broader factors which impact on blood pressure control and to relieve pressures on clinics. Our vision is to revolutionise the treatment of blood pressure, such that all patients are well controlled, saving thousands of lives through fewer heart attacks and strokes."