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The diagnosis and management of adults presenting with high blood pressure (HBP)
Management of hypertension in pregnancy or women with child bearing potential (see NICE CG107), Hypertension in pregnancy)
For more information please refer to the Joint Formulary guidance on hypertension
Please note pre-referral criteria may be applied to referrals for patients with this condition.
To see information required please see Referral Section, referrals submitted without this information may be returned.
Key pre-referral criteria summary:
Hypertension is usually asymptomatic.
BP greater than 180/110
Suspected phaeochromocytoma (labile or postural hypotension, headache, palpitations, pallor and sweating) – admit patient
NICE guidance uses ambulatory or home monitoring to classify as stage 1 or stage 2 hypertension:
Stage 1 hypertension:
Stage 2 hypertension:
Severe Hypertension
For more information please refer to the Joint Formulary guidance on hypertension
Check for end-organ damage
Possible Secondary hypertension: check
Calculate cardiovascular disease (CVD) risk using the QRISK2 http://www.qrisk.org/ risk assessment tool to assess risk for the primary prevention of CVD in people up to and including age 84 years.
Offer lifestyle advice to all
Stage 1 hypertension:
Stage 2 hypertension:
Severe Hypertension
Target levels are BP less than 140/90 in patients aged under 80 and less than 150/90 in those 80 and over.
If patient aged under 55
Step 1
Or
If person aged over 55 or black person of African or Caribbean family origin of any age:
Step1:
Step 2:
Step 3:
Step 4 – Resistant hypertension:
Monitoring drug treatment
For more information please refer to the Joint Formulary guidance on hypertension
Refer to NICE guidance CG127 Clinical management of primary hypertension in adults for more detailed recommendations
Referrals may be returned if the criteria are not evident in the referral letter.
e-Referral Service Selection
GPs and patients can refer to Improving Lives Plymouth for patient support with any long-term physical or low level mental health condition. The service helps people to better manage their condition and to achieve a better quality of life.
NICE guidance CG107 Hypertension in pregnancy:diagnosis and management
This guideline has been signed off by the Western Locality on behalf of NEW Devon CCG
Publication date: November 2017
Updated: October 2018
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