Direct to an emergency department for:
- Hypertensive emergency (blood pressure > 220/140)
- Severe hypertension with systolic blood pressure > 180 mmHg with any of the following:
- blurred vision
- retinal haemorrhage
- reduced level of consciousness
- A pregnant woman with pre-eclampsia with uncontrolled severe hypertension (i.e. diastolic blood pressure > 110 mmHg or systolic blood pressure > 170 mmHg).
Criteria for referral to public hospital specialist clinic services
- Severe persistent hypertension > 180/110
- Refractory hypertension (blood pressure > 140/90) in patients:
- taking three or more antihypertensive medicines
- unable to tolerate maximum treatment.
Information to be included in the referral
Information that must be provided
- Blood pressure measurements, preferably taken on both arms
- Details of all relevant signs and symptoms
- Relevant medical history and comorbidities
- Any treatments previously tried, duration of trial and effect
- Current and complete medication history (including non-prescription medicines, herbs and supplements and recreational or injectable drugs).
Provide if available
- History of smoking and alcohol intake
- Liver function tests
- Full blood examination results
- Fasting lipid profile results
- Estimated glomerular filtration rate (eGFR)
- Urinalysis results
- Urine protein test results
- Renal artery duplex report (if renal artery stenosis is suspected and report is available)
- Previous 12 lead electrocardiogram (ECG) tracings
- Echocardiogram report
- If the person is pregnant or planning pregnancy
- If the person identifies as an Aboriginal and Torres Strait Islander.
The Summary and referral information lists the information that should be included in a referral request.
Consider the possibility of secondary hypertension in younger patients.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for