Who can help

A number of different health professionals can find out what’s going on and help you get your blood pressure under control if it's high.

Who you see will depend on what your blood pressure is, how you’re getting on with any medications and changes to your lifestyle, and any other health problems you may have. The health professionals you see will often be part of a team, for example your GP, practice nurse, healthcare assistants and pharmacist.

There are also other organisations which can offer information and support.

GPs

You will probably be treated by your GP (general practitioner) at your local GP surgery. Many surgeries now hold clinics for people with high blood pressure, which will be run by a GP or practice nurse.

Your GP can diagnose high blood pressure. They can order tests to try to find out what’s causing it and anything else that might be going on. For example, if you have other health problems such as diabetes or kidney problems.

They can give you advice on how to lower your blood pressure with changes to your lifestyle, and can let you know about any local schemes that are available to help, for example exercise schemes.

They are responsible for prescribing medications, and will work with you to find the right ones for you. They can also refer you to the hospital for tests, and to other health professionals and specialists if necessary.

Practice nurses

Practice nurses work together with GPs to diagnose and treat high blood pressure.

Your practice nurses will often monitor your blood pressure and assess your overall health and risk of disease, to see if you would benefit from treatment or a change in treatment. They can also give you information and support to improve your lifestyle, and talk to you about any problems you’re having with your blood pressure and its treatment.

Some practice nurses prescribe medicines, and may be able to change or adjust the dose of your medicines without you needing to see your GP.

Specialist hypertension clinics

Some hospitals and GP surgeries have hypertension clinics. These will be run by a nurse or doctor who specialises in high blood pressure, for example a hypertension nurse specialist.

You might go to a clinic at various times, for example:

• to see if you have high blood pressure
• if you need treatment or a change in treatments
• for support in managing your blood pressure

The specialist will ask you questions about your health and how you’re getting on with any treatment or lifestyle changes. They will measure your blood pressure and perhaps do some other tests to get a good idea of your overall health.

They will decide if you need any new treatment, or if you need to see another health professional for specialist tests or treatments, and can talk to you about what happens next.

Pharmacists

Pharmacist are trained in medicines and how they work. There are many ways they can help, as well as giving you the medicines you’ve been prescribed.

• Getting the most from your medicines
  Pharmacists can give you advice on how and when to take your blood pressure medicines, and how to take them safely. For example, if you should take them with food or drink, any side effects to look out for, and whether driving is safe. They can also let you know if it’s safe to take other medications alongside them, such as anti-inflammatories, painkillers and herbal remedies.
• New Medicines Service. When you first start taking a new blood pressure medicine, you can get extra support from your pharmacist with the new medicines service. You meet with them three times over a month to talk about how to use them safely and effectively and overcome any problems you may have when you first start taking the medicine. Ask your pharmacist about this service.
• Repeat prescriptions. If your blood pressure is well controlled with medications, you might be able to get a repeat prescription from your GP which lasts for up to a year. This means your pharmacist can give you your medications at regular intervals and you don’t need to see your GP every time you need more. They might also be able to have medications delivered to your home if you’re unable to leave the house to collect them. Ask your GP about repeat prescriptions.
• Medicines Use Review (MUR). If you’re taking a number of different medicines, you can ask for a Medicines Use Review. This is a chance to talk about how you’re getting on with your medicines, including any problems you’re having, so they can help you get the most benefit from them.
• Improving your overall health. Pharmacies can offer a range of services and advice to help you make healthy changes. For example, cutting down on alcohol, losing weight and getting active. They sometimes also have stop smoking services with regular catch ups and advice on products.
• Health checks. Some pharmacies also offer blood pressure monitoring and checks on other aspects of your health, such as your blood cholesterol. They carry out NHS Health Checks, which include a number of checks to spot any early signs of illness. You can also ask them about any symptoms of side affects you may have and they can advise you on whether you should see your doctor.

NHS Choices has more on how your pharmacist can help.

Dietitians

Dietitians can help you make changes to your diet. They can talk to you about what you’re eating and the changes you can make to lower you blood pressure, lose weight if you need to, and improve your overall health. You can ask your GP to see a dietitian, or they may refer you.

Dietitians can give specialist advice if you have other health problems linked to high blood pressure, such as diabetes or kidney disease.

Opticians

You might see an optician when you’re diagnosed with high blood pressure so that they can look at the blood vessels at the back of your eyes. This can show if high blood pressure is causing any damage to the blood vessels throughout your body.

Blood pressure specialists

There are some cases where your doctor might refer you to a specialist in high blood pressure. For example, if you’re pregnant, if your high blood pressure is caused by another health problem, if you’re struggling to get your blood pressure under control, or if medications are causing you side effects that you can’t live with.

Younger people are also more likely to see a specialist.  This is because you could be more likely to develop problems in the future as it’s more likely that there could be an underlying health problem, which needs to be investigated.

There are a number of ways a specialist can help.

• Further tests. They can carry out more detailed tests to find out if there is a specific cause for your high blood pressure, which could then be treated.
• Adjusting medications. A specialist can try different combinations of medications and adjusting the dose, to get the right balance between lowering your blood pressure and keeping side effects to a minimum.
• Different medications. They can try medications which are used less often, and medications which are usually used to treat other health problems. For example, 5-PDE inhibitors (5-phosphodiesterase inhibitors), which are usually used to treat erectile dysfunction.
• Clinical trials. Specialists will be able to talk to you about any clinical trials you could enter. Researchers are looking into other options for when the usual medications don’t work well or cause side effects. For example, small implants which can be inserted into an artery where they can affect nerves involved in blood pressure control.

As well as high blood pressure specialists, known as hypertension specialists, you might see specialists with expertise in other health problems that can cause high blood pressure. For example, you might see a specialist in kidney disease if kidney disease could be causing your high blood pressure.

Read more
In our Winter 2017 issue of Positive Pressure, hypertension specialist Dr Manish Saxena explained the research he’s been doing to find treatment options for people whose blood pressure can’t be brought under control with the usual medicines, or who have severe side effects.

Click to print page