High blood pressure (often called ‘hypertension’) is associated with increased risks of stroke, heart failure, heart attack, eye damage and progressive kidney damage. The higher the blood pressure, the higher the risk.
High blood pressure is usually caused by lifestyle factors (e.g. stress, high salt intake, obesity, not enough exercise) combined with an inherited tendency to high blood pressure and genetic factors, and usually starts in middle age. This is called ‘essential hypertension’ and can usually be managed by your own GP, who will advise on lifestyle and may prescribe drug treatment.
High blood pressure can also be caused by kidney diseases and by gland (‘endocrine’) diseases. Treatment of these causes of ‘secondary hypertension’ can sometimes cure, or a least improve the high blood pressure, and/or reduce the number of different drug treatments that a patient has to take to keep the blood pressure under control. it is worth doing tests for these conditions in patients who have unusually high blood pressure and in patients with early onset high blood pressure.
Some people with high blood pressure experience unpleasant side effects when treated with the usual drug treatments, and may benefit from specialist advice on alternative treatment approaches.
Our specialist Hypertension Clinic will assess whether or not you need specialist tests for treatable causes of secondary hypertension or for damage to the heart or kidneys caused by high blood pressure. If the tests suggest that your high blood pressure is caused by kidney disease, we will offer specific treatment and follow-up.
We work in close collaboration with the Endocrine hypertension clinic based at the Royal Victoria Infirmary (RVI), which specialises in endocrine causes of secondary hypertension. So, if our initial tests suggest an endocrine problem, we will refer you onto the Endocrine clinic. if we don’t find a cause for treatable secondary hypertension, we will work with you and your GP to formulate a management plan to keep your blood pressure under control by changes to lifestyle combined with drug treatment.
What you can expect
You will be asked to provide a urine sample for testing and your weight, height and blood pressure will be recorded by the clinic nurse before your consultation with the doctor. The doctor will ask questions and may examine your abdomen (tummy), your pulses, your heart and your eyes. After seeing the doctor you may have some blood tests.
Following your clinic appointment you may be asked to have further tests, including 24h urine collections and you will be given further instructions about these at the time if required
We encourage patients to monitor their own blood pressure and you will be given instruction on how best to do this.
It is very important that we know exactly what drug treatment you are taking, so please bring a complete list of your medicines (including doses) with you. If you have had side effects from blood pressure tablets in the past, it will also be very useful to have a list of the tablets that have caused these problems.
Every patient is different, so there is seldom one treatment that is right for everyone. So we encourage you to prepare questions in advance of your consultation. For instance:
- What are my options?
- What are the benefits and possible risks?
- How likely are these risk and benefits?
After the clinic appointment, you and your GP will receive a letter from the clinic to summarise the consultation and the plans for future tests or treatment.
Further information is available from a variety of sources including:
http://www.bpassoc.org.uk for general information on high blood pressure
http://www.nice.org.uk/guidance/cg127/informationforpublic is from the National Institute for Health and Care Excellence (NICE). NICE provide guidelines on how manay medical considtions should be treated in the NHS.
Advice from NICE for patients with diabetes as well as high blood pressure can be found at http://www.nice.org.uk/guidance/cg87/informationforpublic
http://www.nhs.uk/conditions/Blood-pressure-(High)/Pages/Introduction.aspx is another good source of patient friendly information
http://www.bhsoc.org//index.php?cID=246 for a list of approved home blood pressure monitors