Hypertension Clinic – E-Mail Advice

The purpose of this service is to provide
rapid access to advice on specific issues that might include

• Whether to initiate antihypertensive drugs in borderline cases
• Whether to escalate antihypertensive therapy
• How to escalate drug therapy in patients with contra-indications/side-effects
• Whether to initiate lipid-lowering drugs or aspirin
• How to interpret basic investigations (see list below)
• Whether to refer for ambulatory blood pressure monitoring
• Whether to refer to the Cardiovascular Risk Clinic for further assessment

This list is not exhaustive but reflects some of the more common
problems to which the service is particularly suited. It is worth noting
that, although we are happy to try to deal with any issues relating to
the investigation and treatment of patients with cardiovascular risk
factors, the more supporting information that can be provided the
greater the chances of providing a definitive response. The following
represents an ideal dataset on which to base our guidance

Patient factors	Investigations
Age Sex Personal history of cardiovascular disease Current drugs (and any rejected drugs) Smoking history	Electrolytes Creatinine Glucose Liver function Total cholesterol HDL
Other factors that may be of relevance Family history of cardiovascular disease Alcohol intake Body mass index Obstetric history	Other factors that may be of relevance ECG Urine dipstick Gamma-GT Thyroid function Triglycerides Urate HbA1c