High Blood Pressure Management Online

What is high blood pressure?

High blood pressure, also known as hypertension, is a condition where the force of blood against your artery walls is consistently too high. It affects approximately 6 million Australian adults, and many do not know they have it because it often has no symptoms. Blood pressure is measured in millimetres of mercury (mmHg), and hypertension is generally diagnosed when readings are consistently above 140/90 mmHg.

High blood pressure is a major risk factor for heart disease, stroke, kidney disease, and other serious health conditions. It is sometimes called the "silent killer"because it can cause significant damage without noticeable symptoms until a serious event occurs.

High blood pressure may be managed with lifestyle changes and, where appropriate, medication. Regular monitoring and ongoing GP support can help you work towards keeping your blood pressure within a healthy range. Your GP will assess your individual circumstances.

When to see a doctor about high blood pressure

All adults should have their blood pressure checked regularly. You should see a GP if a pharmacy or home blood pressure reading shows elevated results, if you have a family history of high blood pressure or heart disease, or if you have risk factors such as being overweight, smoking, high salt intake, or a sedentary lifestyle.

If you are already on blood pressure medication, regular GP reviews are essential to ensure your treatment is working effectively and to monitor for any side effects. Seek urgent medical attention if you experience severe headache, chest pain, vision changes, or difficulty breathing, as these may indicate dangerously high blood pressure.

How a telehealth GP can help with high blood pressure

A NewDoc telehealth GP can review your blood pressure readings, assess your cardiovascular risk factors, and prescribe or adjust blood pressure medications. Telehealth is well suited for ongoing blood pressure management, medication reviews, and prescription renewals, particularly if you have a home blood pressure monitor.

Your GP can also order blood tests to check cholesterol, blood sugar, and kidney function, create a GP Management Plan for Medicare-subsidised allied health services (such as dietitian or exercise physiology), and refer you to a cardiologist if specialist input is needed.

Risk factors for high blood pressure

A number of factors may increase your risk of developing hypertension. Some of these are non-modifiable, including age, family history of high blood pressure, and existing conditions such as diabetes, kidney disease, or sleep apnoea. Cardiovascular risk tends to increase as you get older, and having a close relative with hypertension may make you more likely to develop it yourself.

Other risk factors are modifiable, meaning lifestyle changes may help reduce your blood pressure or delay its onset. These include high salt intake, excess alcohol consumption, being overweight or obese, physical inactivity, smoking, and chronic stress. Even modest improvements in these areas may contribute to better blood pressure management over time.

Your GP will assess your individual risk profile during a consultation. An online GP in Australia can review your history, discuss which risk factors apply to you, and recommend a personalised plan that may include lifestyle modifications, monitoring, or further investigation. Bulk billed telehealth makes it easier to have these conversations regularly without the need to visit a clinic in person.

Blood pressure medications: the four main classes

Lifestyle changes are first-line — reducing salt to under 5 g daily, regular aerobic exercise (150 minutes/week), Mediterranean-style diet (DASH), limiting alcohol to under two standard drinks daily, quitting smoking, and weight loss where relevant. When lifestyle alone is insufficient, Australian Therapeutic Guidelines (eTG) and the National Heart Foundation recommend medication, starting with one of these four first-line classes:

ACE inhibitors — first-line, especially with diabetes or kidney disease

• Perindopril 5–10 mg daily (Coversyl, Perindo) — widely prescribed first-line ACE inhibitor
• Ramipril 5–10 mg daily — alternative ACE inhibitor with strong cardiovascular evidence
• Lisinopril, Trandolapril — additional ACE options

Side effects to watch for: dry cough (10–15% of patients), elevated potassium, reduced kidney function (monitor with bloods 2–4 weeks after starting).

ARBs (angiotensin receptor blockers) — for ACE-intolerant patients

• Losartan 50–100 mg daily (Cozaar)
• Telmisartan 40–80 mg daily (Micardis)
• Irbesartan (Avapro), Candesartan (Atacand) — additional ARB options

ARBs are preferred when ACE inhibitors cause cough. They are contraindicated in pregnancy.

Calcium-channel blockers — particularly effective in older adults

• Amlodipine 5–10 mg daily (Norvasc) — most commonly prescribed calcium-channel blocker
• Felodipine, Lercanidipine (Zanidip) — alternatives

Common side effect: ankle swelling (typically mild, often improves on dose reduction).

Thiazide-like diuretics — long-established and inexpensive

• Indapamide 1.5 mg daily (modified-release)
• Hydrochlorothiazide 12.5–25 mg daily

Often combined with ACE/ARB; monitor sodium, potassium, and uric acid.

Combination tablets and add-on agents

Most patients ultimately need two or more medications. Fixed-dose combinations improve adherence and reduce pill burden:

• Coveram (perindopril + amlodipine)
• Sevikar (olmesartan + amlodipine)
• Twynsta (telmisartan + amlodipine)

Add-on options for resistant hypertension include beta-blockers (bisoprolol, atenolol, metoprolol), spironolactone (Aldactone — for resistant hypertension after 3 agents), and alpha-blockers (prazosin). Your GP will tailor the regimen to your blood-pressure target, age, comorbidities, and tolerability.

Regular home blood pressure monitoring is recommended. Your GP can advise on the correct technique. Ongoing reviews keep your medication effective and address other cardiovascular risk factors. A Chronic Disease Management Plan gives Medicare-rebated allied health (dietitian, exercise physiologist) to support lifestyle.

Monitoring your blood pressure at home

Home blood pressure monitoring may help you and your GP track your readings between appointments and make more informed decisions about your treatment. It can also help identify white coat hypertension, where blood pressure readings are higher in a clinical setting than at home. Many people find that regular monitoring gives them a greater sense of involvement in their own blood pressure management.

When choosing a monitor, a validated upper arm device is generally recommended over wrist models, as upper arm monitors tend to provide more consistent results. Your pharmacist or GP can advise on suitable options. It is worth checking that the cuff size fits your arm correctly, as an ill-fitting cuff may affect the accuracy of your readings.

For accurate results, sit quietly for at least five minutes before taking a reading. Sit with your back supported, feet flat on the floor, and your arm resting at heart level on a table or armrest. Avoid caffeine, exercise, and smoking for at least 30 minutes beforehand. Try to take your readings at the same time each day, such as in the morning and evening, to build a consistent picture of your blood pressure patterns.

Keep a log of your readings, including the date, time, and both systolic and diastolic values. Many home monitors store readings automatically, or you can use a simple notebook or app. Sharing this log with your GP during a bulk billed telehealth consultation can help them assess whether your current treatment plan is working effectively.

As a general guide, home readings consistently above 135/85 mmHg may warrant a conversation with your GP. Very high readings, such as above 180/110 mmHg, or readings accompanied by symptoms like severe headache, chest pain, or vision changes, require urgent medical attention. Your GP will assess your individual targets and advise on what readings should prompt you to seek further care.