Hypertension

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Severe persistent hypertension (>180/110) without concerning features 
    • headache
    • confusion
    • blurred vision
    • retinal haemorrhage
    • reduced level of consciousness
    • seizures
    • proteinuria
    • papilloedema
  • that persists after trial of oral medication as described by the Heart Foundation Hypertension Guideline

Category 2

Appointment within 90 days is desirable

  • Medication intolerance
  • Suspected renal artery stenosis (consider referral to vascular if available)
  • Refractory hypertension patients on three or more medications with BP >140/90

Category 3

Appointment within 365 days is desirable

  • Changing pattern of hypertension

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Consider testing for primary hyperaldosteronism, and phaeochromocytoma
  • The Heart Foundation Hypertension Guidelines provide some additional guidance for patient management
  • Refer to HealthPathways for assessment and management information if available

Referral requirements

A referral may be rejected without the following information.

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • BP (BP measurements on both arms preferable)
  • Relevant previous medical history and co-morbidities
  • FBC, ELFTs, eGFR, fasting lipids results
  • Urinalysis results
  • Urinary protein estimation results or albumin creatinine ratio
  • CXR report
  • ECG

Additional Referral Information (Useful for processing the referral)

  • Stress test report (if available)
  • Any investigations relevant to co-morbidities
  • Renal duplex report if renal artery stenosis suspected
  • History of smoking, alcohol intake and drug use (including recreational drugs)
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • 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
  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)