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:
    • headache
    • confusion
    • blurred vision
    • retinal haemorrhage
    • reduced level of consciousness
    • seizure(s)
    • proteinuria
    • papilloedema
  • 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.

Additional comments

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.

See also obstetrics statewide referral criteria for Pre-eclampsia and Maternal medical conditions (which includes referrals for severe, refractory hypertension).

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

Not applicable