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Hypertension

Red flags

The following require immediate transfer to hospital for emergency treatment:

  • Hypertensive crisis characterised by:
    • Systolic BP >180mmHg associated with specific symptoms and signs including:
      • Headache
      • Confusion
      • Blurred vision
      • Reduced level of consciousness
      • Seizures
      • Proteinuria

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

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.

Essential referral information

  • General referral 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)

Out of catchment!

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • 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.)
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