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Hypertension is the commonest risk factor contributing to the global burden of disease. Public Health England estimates that, in England, 24% of the population are hypertensive, with 40% possibly undiagnosed. With this in mind, dentists, in particular those undertaking sedation, are in a perfect position to screen for high blood pressure and refer on for further detailed assessment. This paper outlines when a referral to the General Medical Practitioner (GP) should be considered, when sedation should be deferred and how hypertension is diagnosed and managed in primary care based on the National Institute for Health and Care Excellence (NICE)/British Hypertension Society (BHS) guidelines.
CPD/Clinical Relevance: The purpose of this article is to update General Dental Practitioners (GDPs), including those who practise IV Midazolam sedation, on how patients who present with suspected hypertension are managed by their GP. Consideration is given to what blood pressures are deemed safe to sedate and what blood pressures should be referred for further assessment, even if considered safe to sedate.
Article
Hypertension is outlined as the commonest risk factor contributing to the global burden of disease.1,2 Based on the health survey for England 2013/4, Public Health England estimates that 13.4 million people in England alone (24% of the population) are hypertensive, with possibly as many as 40% undiagnosed.3 This means that, potentially, two in five adults attending any dental practice, for any treatment, may be hypertensive and are, as yet, undiagnosed. It is one of the most important preventable causes of premature morbidity and mortality in the UK, being a major risk factor for stroke, myocardial infarction, heart failure, chronic kidney disease and cognitive decline.4 With each 2 mmHg rise in systolic BP associated with a 7% increased risk of mortality from ischaemic heart disease and a 10% increased risk of mortality from stroke, the individual and societal health burdens of the condition are clear.
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