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Medical same day emergency care (MSDEC) referrals to the Hypertension clinic

This page is intended for use by clinicians at Queen Elizabeth Hospital Birmingham as a guideline for referring patients to the Hypertension clinic.

For management of hypertensive urgency and hypertensive crisis, please see the hypertensive crisis guidelines on the intranet (you will need to be on a Trust networked device to access intranet pages).

Indications for referral to the Hypertension clinic

  • Young-onset hypertension < 30 years of age (without obvious causes such as morbid obesity with BMI > 40 kg/m2, high sodium intake (>6g/daily), high alcohol intake (>14 units/weekly) or strong family history of hypertension)
  • Younger onset hypertension aged 30-40 years and with BMI < 30 kg/m2
  • Resistant hypertension (clinic BP > 140/90 mmHg despite good adherence with three or more antihypertensive drugs)
  • Multiple drug intolerances (adverse reactions to at least three or more antihypertensive drugs)
  • Suspected but disputed or unproven non-adherence (objective urine testing can be performed)
  • Uncontrolled hypertension with refusal of oral antihypertensive treatment by the patient
  • Nurse led 24-hour ambulatory pressure monitor (ABPM) (if the patient is unable to complete themselves or GP is unable to)

How to refer to the Hypertension clinic

  • Refer all patients via PICS (Request > Hypertension outpatient referral)
  • Ensure the patient’s height and weight are documented on PICS
  • Ensure the address and contact number of the patient are up-to-date and included
  • Current wait time for an Outpatient appointment is six months
  • Advise the patient to follow up with their GP in the interim and give appropriate safety netting

Patient advice for management of hypertension

  • Offer appropriate lifestyle advice and advise the patient to visit the NHS hypertension website
  • Advise patient to buy a home BP monitor (e.g. Omron M2 Basic). See the British and Irish Hypertension Society (BIHS) website for other approved BP monitors
  • Advise patients to keep a blood pressure diary (e.g. take two readings back-to-back, two to three times a day for one to two weeks) and consult with their GP whilst waiting for their appointment

Last reviewed: 04 October 2024