Hypertension Care

If you are at risk of developing high blood pressure or already have high blood pressure and take medication for this or take medication that could cause your blood pressure to rise or have diabetes, heart disease, had a stroke, have chronic kidney disease, suffer with headaches then it is important that you monitor your blood pressure. Many people would usually come to the GP practice to check their blood pressure. However, you may wish to consider buying a blood pressure machine so that you can safely monitor your blood pressure and pulse too in the comfort of your own home and also measure it over a week. It also means other family members and friends can also use it to check their own blood pressure too.

The price of blood pressure machines has dropped and you can buy a good one from about £19.99. If you plan to buy one, please ensure it is clinically validated.

• Home blood pressure monitoring
• Why measure your blood pressure with a home blood pressure monitor?
• Choosing your monitor
• How to measure your blood pressure at home
• When to use your blood pressure monitor

Ideally you should check your blood pressure 3 times,waiting 1 minute after checking your blood pressure each time and then noting down the lowest readings of the 3.

Repeat this again twice a day for a week

Take an average of the top readings and the bottom readings so that you have an average blood pressure reading over the week.

This gives us a better understanding of what your blood pressure is like

If your blood pressure is very high (more than 180/120) then you should get in touch with the surgery sooner or call 111

Helping patients with HYPERTENSION (High Blood Pressure) to get the best from your doctor and the NHS.

95% of patients with high blood pressure suffer with Essential Hypertension which means “high blood pressure of unknown cause”. A few patients develop Hypertension for another cause which you can find in your GP-held electronic health record.

Here are some links for hypertension that you may wish to see:

• NHS Choices:
• Summary info:
• British Heart Foundation: High blood pressure
• Guide: High, low and normal blood pressure readings explained
• Lifestyle: How to lower your blood pressure
• Healthy Blood Pressure Diet
• High blood pressure medication
• How to use a blood pressure monitor

This condition is primarily managed by the nurses. They can check your blood pressure readings, order tests and review them, check any problems you may be encountering and do a medication review for you. They can also advise on things you may wish to consider and discuss things that you may have learned during your journey of discovery.

The health care assistants can check your height and weight and do any blood tests you may need as well as check your urine sample.

Doctors can see patients whose blood pressure is not getting under control or if you are having difficulties due to possible side effects.

There is a blood pressure machine in the waiting room for you to check your blood pressure whenever you come to the practice or you can monitor your blood pressure at home.

You need to know what your target blood pressure should be and what other risk factors you have that need to be managed eg whether you smoke or not or if you are obese or whether you suffer with diabetes or raised cholesterol. You also need to know what is expected of you in the course of a year even if your blood pressure is well-controlled. You should monitor your own blood pressure, weight and mood at home and store your readings in the “My GM Care app“. You can also check you weight and smoking status, blood tests and urine test via your NHS app (or equivalent) to see what information we have about you and any advice your doctor or nurse has provided you. Use this web resource to get the best from the practice and learn what blood pressure means too.

The typical patient with hypertension which is well controlled needs the following:

• Fasting blood tests and urinalysis once a year with the healthcare assistant– checking their kidney function (Sodium, Potassium, Urea, Creatinine and eGFR), Liver function tests, lipid profile (Cholesterol, HDL, LDL, triglycerides) , diabetes status (glucose) and urinalysis (dip stick urine checking for protein and blood)
• Blood Pressure reading at least twice a year 6 months apart. You can do this on your own! This is the minimum needed but you are encouraged to do this more often by using the practice blood pressure machine in the waiting room or buying a blood pressure machine yourself so that you can monitor it at home / work yourself. The local pharmacies all sell reasonably priced blood pressure machines and can give you more details about them. You can store your readings on the “My GM Care app“
• Your smoking status updated
• Medication Review twice a year usually with the nurse unless you are told otherwise

• As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control.
• Get access to your GP-held record via the NHS app or equivalent. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice.
• Ideally we want you to book in with the healthcare assistant for fasting blood tests and urine test if you have not had them done for 12 months or prior to your next medication review. At the same time, ask to book in with the nurse a week later. The nurse will check your records and book you in for you. (This is because the nurse needs to check who is the most appropriate person to do the medication review dependent on what else you may also suffer with).
• Remember to ask for a yellow topped urine bottle from the receptionist which you can bring with you when you have your blood tests. You can do this when you turn up to the surgery and are waiting for the healthcare assistant or bring it with you.
• We calculate your risk of having a heart attack in the next 10 years by using the QRisk score (www.qrisk.org) . This takes account of your age, post-code, sex, diabetes, status, smoking status, blood pressure and Cholesterol: HDL ratio. If the risk is greater than 20% then you will need to start a statin therapy (eg simvastatin) as well as dietary advice to help lower your cholesterol level. You can see your QRisk in the values section of your GP-held electronic health record. For patients with just hypertension (ie not diabetes or ischaemic heart disease), we use this score as a way of determining whether you need to be on a statin or not. Click here for further details about statins.
• Show your blood pressure readings via the “My GM Care app” or ask your doctor or nurse to check themselves the readings if you have been checking them at home. They can view the readings via the GM Care record that they have access to also.