Hypertension

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

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

    Pathology:

  • FBC
  • UEC
  • LFTs
  • eGFR
  • lipid results (chol, TG, HDL, LDL)
  • Urinalysis results
  • Urinary protein estimation results or albumin creatinine ratio

    • Imaging:

  • CXR report

    • Investigations:

  • ECG
  • BP (BP measurements on both arms preferable)

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

Hypertensive emergency (BP>220/140)
Severe hypertension (systolic BP >180) with known ischaemic heart disease or cardiomyopathy AND any of the following concerning features:

  • headache
  • confusion
  • blurred vision
  • retinal haemorrhage
  • reduced level of consciousness
  • seizures
  • proteinuria
  • papilloedema
  • signs of heart failure
  • chest pain

If suspected pregnancy induced hypertension or pre-eclampsia refer patient to the emergency department of a facility that offers obstetric services where possible.

Urgent / category 1

Severe persistent hypertension (>180/110 but below 220/140) in patients with known ischaemic heart disease or cardiomyopathy) without emergency referral concerning features (Select to display above)

Severe persistent hypertension that persists after trial of oral medication as described by the WHO Guideline for the pharmacological treatment of hypertension in adults:

Guideline for the pharmacological treament of hypertension in adults)

Semi-urgent / category 2

* Hypertensive medication intolerance
* Suspected renal artery stenosis, noting this may be on-referred to Vascular
* Refractory hypertension (>140/90 but <180/110) in patients with known ischaemic heart disease or cardiomyopathy and receiving 3 or more antihypertensive agents

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).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

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

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