There are potentially 13 million adults in the UK and Ireland who have raised blood pressure that requires treatment.1 While the majority of patients with hypertension are well managed in primary care, there is a significant proportion who need specialist care. Approximately 10% of patients have complex hypertension that requires specialist input,2,3 but the provision of specialist clinics is poorly distributed throughout the UK and Ireland, making access for patients inequitable. GPs need support in managing these complex hypertension cases and they need to be aware of the limitations that currently exist in accessing that care for those patients.

It is important that GPs are aware that in the UK there is currently no specialist registration for hypertension doctors and the only medical training that includes a specific module in hypertension is the specialism of clinical pharmacology and therapeutics. Most clinical pharmacologists who work in specialist clinics are sited in major cities or based within university departments with an academic interest in hypertension. Thus, many GPs are forced to refer patients with complex hypertension to their local cardiology department. Very few cardiologists have any specialist training in hypertension and may not offer much more than the advice already offered by the National Institute for Health and Care Excellence (NICE).2 Many will not have experience managing hypertensive crises or have access to the specialist …