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Hypertension (General Medicine)

ADULT

Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Severe hypertension (>180/110 but below 220/140) in patients over age 50 years with no known ischaemic heart disease, cardiomyopathy, or chronic kidney disease and without 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 gestational hypertension or pre-eclampsia refer patient to the emergency department of a facility that offers obstetric services where possible.
  • Category 2
    (appointment within 90 calendar days)
    • Refractory hypertension (>140/90 but below 180/110) in patients over age 50 years and receiving 3 or more antihypertensive agents
  • Category 3
    (appointment within 365 calendar days)
    • Patients over 50yrs age with hypertension not reaching target BP levels despite 2 antihypertensive agents

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

  • Presence of comorbid conditions such as diabetes or vascular disease
  • List of medications including details of all treatments offered and efficacy
  • History of BP measurements including 24-hour measurements or home measurements if available
  • FBC, ELFT, eGFR, ECG, CXR results
  • Urine albumin creatinine ratio (ACR) or urine protein creatinine ratio (PCR) (ideally early morning sample but a random sample is acceptable)
  • Urinalysis

3. Additional referral information Useful for processing the referral

  • History of smoking, alcohol intake and drug use (including recreational drugs)
  • Ethnicity (Aboriginal and Torres Strait Islander population especially at risk)
  • Any investigations relevant to co-morbidities

4. Request

Last updated: 13 June 2023