Hypertension

Availability

North South North West Statewide

Pre-referral work-up

History

Direct referral to Cardiology Clinic

All referrals should comply to the Referral Standards and must include:

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • BP (BP measurements on both arms preferable)
  • Relevant previous medical history and co-morbidities

Tests

  • FBE
  • U&Es, Creatinine
  • Blood glucose, HbA1c if diabetic
  • ECG
  • Urinalysis results
  • Urinary protein estimation results or albumin creatinine ratio
  • CXR
  • Refer for 24hr ambulatory BP monitor - if possible

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

Additional information which may assist triage:

  • Any investigations relevant to co-morbidities
  • Stress test report (if available)
  • Renal duplex report if renal artery stenosis suspected
  • History of smoking, alcohol intake and drug use (including recreational drugs

Interim management advice for Hypertension can be found on HealthPathways.

For more information please see the Tasmanian Health Pathways website.

Emergency

Malignant hypertension

Urgent / category 1

Severe persistent hypertension (>180/110) without concerning features:

  • headache
  • confusion
  • blurred vision
  • retinal haemorrhage
  • reduced level of consciousness
  • seizures
  • proteinuria
  • papilloedema

that persists after trial of oral medication as described by the Heart Foundation Hypertension Guideline

Semi-urgent / category 2

  • Medication intolerance
  • Suspected renal artery stenosis (consider referral to vascular if available)
  • Refractory hypertension patients on three or more medications with BP >140/90

Routine / category 3

  • Changing pattern of hypertension

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH
ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within one week, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within four weeks

Routine:

Next available appointment usually within eight weeks