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NICE has provided clear recommendations for identifying individuals who require same-day specialist assessment in cases of hypertension. . The table below outlines the criteria for such referrals, ensuring timely interventions and appropriate management. Please also refer to our chart on hypertensive crises for a better understanding of this subject.
| Criteria | Recommendations |
|---|---|
| Severe Hypertension (180/120 mmHg or higher) without Symptoms or Signs indicating same-day referral | - Conduct investigations for target organ damage promptly. |
| Target Organ Damage Identified 🔴 | - Consider initiating antihypertensive drug treatment immediately if target organ damage is found, regardless of ABPM or HBPM results. |
| No Target Organ Damage Identified | - Confirm diagnosis: a) Repeat clinic blood pressure measurement within 7 days, or b) Consider ABPM or HBPM if suitable, following guidelines for monitoring. Ensure clinical review within 7 days. |
| 👉Same-Day Specialist Assessment | - Refer individuals with clinic blood pressure of 180/120 mmHg and higher with: a) Signs of retinal haemorrhage or papilloedema (accelerated hypertension), or b) Life-threatening symptoms like new onset confusion, chest pain, signs of heart failure, or acute kidney injury. |
| 👉Same-Day Specialist Assessment for Suspected Phaeochromocytoma | - Refer individuals with suspected phaeochromocytoma (labile or postural hypotension, headache, palpitations, pallor, abdominal pain, or diaphoresis) for same-day specialist... |
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