a) Follow-up should include:
1. Necessary blood work (serum potassium and creatinine, every 6-12 months)
2. Blood pressure measure and weight
3. Enquiry regarding general health status, side effects and any treatment
4. Reinforce or advise on non-pharmacological measure to control blood pressure
5. Annual urine test for proteinuria
b) With Stage 2 (consistent with Grade 2 of the WHO/ISH classifications) or complicated hypertension, clients require more frequent follow-up
➪ Practice Point:
Factors to consider when target blood pressure is not being reached:
- Difficulty following treatment regimen (e.g., complexity, socioeconomic barriers, psychological factors).
- Lifestyle (e.g., inability to lose weight, excessive alcohol intake).
- Treatment prescribed may be ineffective.
- Isolated clinic (white-coat) hypertension.
- Use of inappropriate cuff size.
- Use of drugs that raise blood pressure (e.g., NSAIDs, sympathomimetics, herbal remedies)
- Volume overload (e.g., high sodium intake, renal insufficiency, inadequate or ineffective diuretic therapy)
- Unsuspected secondary cause (e.g., renal or endocrine disorders, sleep apnea).