Ronnie fails to attend his last two annual hypertension review appointments and has not attended for his flu jab. The practice nurse notices this and phones to arrange a time that is suitable for Ronnie to attend. She reviews Ronnie’s notes before he comes in to the room for his appointment.
The practice nurse notices that Ronnie’s blood pressure is not within target, despite him being prescribed 3 antihypertensive medications.
One possible conclusion is that he has resistant hypertension.
This occurs in approximately 1% of people with hypertension. In resistant hypertension, it is essential that they are referred to secondary care for further review. However, before assuming that this is resistant hypertension, it is important to go back to basics and review Ronnie, ensuring that all tests and investigations have been carried out.
Secondary Hypertension NICE Guidelines
PATIENT DATABASE v.4.2
Name: Ronald Smith
Age: 62
PMH: Hypertension with LVH
MEDS:
- Amlodipine 10mgs OD
- Ramipril 10mgs OD
- Bendrofuamethazide 2.5mgs OD
- Gaviscon PRN
Blood pressure: 158/91 mmHg
Pulse: 78 and regular
Allergies: Nil
Page last reviewed: 17 Sep 2020
