Hypertension (General Medicine)
-
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- Hypertensive emergency (BP>220/120 mmHg)
- Severe hypertension (systolic BP >180 mmHg) with any of the following concerning features:
- headache
- confusion
- blurred vision
- retinal haemorrhage
- reduced level of consciousness
- seizures
- proteinuria
- papilledema
- signs of heart failure
- chest pain
- acute kidney injury
- If suspected gestational induced hypertension or pre-eclampsia refer patient to the emergency department or maternity assessment unit of a facility that offers obstetric services where possible.
- Phaeochromocytoma in crisis with uncontrolled hypertension
-
| Category 1 (appointment within 30 calendar days) |
All hypertension referrals would be triaged to General Medicine, unless the referral contains specific clinical indicators warranting sub-specialist review. Referrals may be allocated to Kidney Medicine, Cardiology, or Endocrinology where clearly justified by comorbidities, diagnostic complexity, or suspected secondary causes of hypertension.
Subspeciality referral for the following:Cardiology
Kidney Medicine:
Endocrinology:
|
| Category 2 (appointment within 90 calendar days) |
Subspeciality referral for the following:Cardiology
Kidney Medicine:
Endocrinology:
|
| Category 3 (appointment within 365 calendar days) |
Subspeciality referral for the following:Cardiology
Kidney Medicine:
Endocrinology:
|
Please insert the below information and minimum referral criteria into referral
1. Reason for request Indicate on the referral
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
2. Essential referral information Referral will be returned without this
- Medical History & Clinical Background:
- Detailed medical history emphasising any cardiac, renal, or endocrine concerns.
- History of blood pressure (BP) measurements (preferred both arms), including 24-hour or home measurements if available.
- Current medication list, including over the counter (OTC) medications, and detailing all treatments tried, including efficacy.
- Cardiac Investigations:
- Electrocardiogram (ECG).
- Echocardiogram*
- Fasting lipid profile.
- Renal Investigations:
- Renin and aldosterone levels.
- Estimated Glomerular Filtration Rate (eGFR).
- Urinalysis results.
- Urine midstream M/C/S (microscopy/culture/sensitivity) for infection, morphology, and casts.
urine albumin:creatinine ratio - Renal artery assessment via renal duplex report (if stenosis is suspected).
- Endocrine Investigations:
- 1mg dexamethasone suppression test and/or 24-hour urinary free cortisol levels.
- Plasma free metanephrine and normetanephrine levels.
- Imaging & Other Diagnostic Tests:
- Chest X-ray report.
- Laboratory Investigations:
- Full Blood Count (FBC).
- Electrolytes, Liver Function Tests (LFTs).
Note: *Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
3. Additional referral information Useful for processing the referral
- History of smoking, alcohol intake and drug use (including recreational drugs)
- Ethnicity highlighting Aboriginal and Torres Strait Islander population especially at risk
- Records and results of investigations pertinent to co-morbidities or tests excluding other secondary causes (e.g., sleep studies).
4. Request
-
Patient's Demographic Details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
-
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
Last updated: 3 July 2025
© State of Queensland (Queensland Health) 2023
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