High Blood Pressure Treatment | Hypertension Specialist Naas, Kildare, Ireland

Cardiology · Naas, Co. Kildare

Hypertension & Blood Pressure Management

Specialist assessment for high blood pressure, resistant hypertension and secondary causes. Ambulatory monitoring, cardiovascular risk stratification and personalised management plans.

Dr Imtiaz Ali Kalyar — Consultant Cardiologist IMC: 102093 Sunday Clinics Available

Overview

Understanding Hypertension

Hypertension — persistently elevated blood pressure — is one of the most significant modifiable risk factors for cardiovascular disease, stroke and chronic kidney disease. Despite its prevalence, hypertension is frequently undertreated, partly because it causes no symptoms until complications arise, earning it the name "the silent killer."

Blood pressure is classified by guidelines into stages. Stage 1 hypertension is typically defined as sustained readings of 140–159 mmHg systolic or 90–99 mmHg diastolic. Stage 2 hypertension refers to readings consistently at or above 160/100 mmHg. Hypertensive urgency and emergency involve very high readings with associated symptoms or end-organ damage and require immediate medical attention.

The majority of cases represent essential (primary) hypertension — elevated blood pressure without an identifiable secondary cause. However, in a meaningful proportion of patients, particularly younger individuals and those with resistant hypertension, a secondary cause such as renal artery stenosis, primary hyperaldosteronism or sleep apnoea may be present and is treatable.

This page is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999 or 112.

Hypertensive emergency: A very high blood pressure reading (typically above 180/120 mmHg) associated with symptoms such as severe headache, visual disturbance, chest pain or breathlessness constitutes a hypertensive emergency. Please attend an Emergency Department immediately or call 999.

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Essential Hypertension

Accounts for 90–95% of cases. Caused by a combination of genetic predisposition and lifestyle factors including diet, physical inactivity, excess weight and stress.

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Secondary Hypertension

An identifiable cause is present in 5–10% of cases. Causes include renovascular disease, primary aldosteronism, thyroid disorders and obstructive sleep apnoea.

Specialist Assessment

Resistant Hypertension & ABPM

Resistant hypertension is defined as blood pressure that remains above target despite the use of three or more antihypertensive agents at optimal doses, including a diuretic. A specialist assessment in this setting is essential to exclude pseudo-resistance (poor adherence, white-coat effect), identify secondary causes and optimise therapy.

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Ambulatory Blood Pressure Monitoring (ABPM)

ABPM records blood pressure automatically at regular intervals over 24 hours during normal daily activities and sleep. It is the gold standard for diagnosing hypertension and identifying white-coat hypertension, masked hypertension and nocturnal dipping patterns.

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End-Organ Assessment

Hypertension causes damage to the heart, kidneys and blood vessels over time. ECG (for left ventricular hypertrophy), echocardiogram, and renal function tests help quantify this damage and guide management intensity.

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Secondary Cause Screening

Where clinically indicated, targeted investigations for secondary hypertension including aldosterone-to-renin ratio, renal imaging and thyroid function are arranged to identify reversible causes.

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Treatment Optimisation

Lifestyle modifications (dietary sodium reduction, increased physical activity, weight loss and alcohol reduction) are fundamental. Pharmacological therapy is tailored to individual co-morbidities and tolerability, following evidence-based guidelines.

Cardiovascular Risk

Hypertension & Cardiovascular Risk Assessment

Blood pressure does not exist in isolation. Dr Kalyar performs a comprehensive cardiovascular risk assessment to understand the full context of your blood pressure in relation to your other risk factors — cholesterol, blood glucose, smoking status, family history and age — and uses validated risk scoring tools to guide treatment intensity and targets.

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SCORE2 Risk Stratification

European risk scoring tools calculate your 10-year risk of a fatal or non-fatal cardiovascular event. This guides treatment thresholds and targets for blood pressure and other risk factors.

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Comprehensive Blood Tests

Full lipid profile, fasting glucose or HbA1c, renal function, electrolytes and urine protein help quantify risk and assess for hypertension-related end-organ damage.

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Echocardiography

Identifies left ventricular hypertrophy and diastolic dysfunction — important markers of hypertensive heart disease that influence prognosis and treatment decisions.

Common Questions

Frequently Asked Questions

What blood pressure reading is considered too high?

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Blood pressure is measured in mmHg and expressed as two numbers: systolic (during heartbeat) over diastolic (between beats). A blood pressure consistently at or above 140/90 mmHg is generally considered hypertensive and warrants investigation and consideration of treatment. Single readings may be transiently elevated due to anxiety or exertion; a diagnosis of hypertension is made based on sustained elevation confirmed by multiple measurements or ambulatory blood pressure monitoring. Please consult your doctor for personalised guidance on your specific readings.

What is resistant hypertension?

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Resistant hypertension is defined as blood pressure that remains above the target level despite optimal doses of three or more antihypertensive medications from different classes, typically including a diuretic. It affects a meaningful minority of patients with hypertension and warrants specialist evaluation to exclude pseudo-resistance (such as poor medication adherence or a white-coat effect), identify secondary causes, and optimise the medication regimen. A specialist cardiologist consultation is recommended in this setting.

What is ambulatory blood pressure monitoring (ABPM)?

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ABPM involves wearing a blood pressure monitor for 24 hours, which automatically inflates the cuff and records readings at regular intervals throughout the day and night. It captures blood pressure during normal daily activities and during sleep, providing a much more comprehensive picture than clinic readings alone. ABPM is the gold standard for confirming a diagnosis of hypertension, identifying the "white-coat effect" (elevated readings only in a clinic setting), and detecting masked hypertension (normal clinic readings but elevated ambulatory readings).

Can hypertension be cured?

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In the small proportion of patients where a secondary cause is identified and treated (for example, removal of an adrenal tumour causing primary aldosteronism, or treatment of renovascular disease), blood pressure may normalise without ongoing medication. For the majority with essential hypertension, the condition is managed rather than cured. Sustained lifestyle changes — particularly weight reduction, dietary sodium restriction, regular physical activity and reduced alcohol consumption — can produce meaningful reductions in blood pressure, and some patients may be able to reduce or discontinue medication under medical supervision.

When should I see a specialist for high blood pressure?

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Consider a specialist cardiology referral if your blood pressure is not controlled despite treatment with multiple medications, if a secondary cause of hypertension is suspected, if you have evidence of hypertensive end-organ damage (left ventricular hypertrophy, renal impairment, proteinuria), if you are young and have severe hypertension, or if you need a comprehensive cardiovascular risk assessment. Your GP can refer you, or you can self-refer to our private clinic by contacting us directly.

Book a Cardiology Appointment

Specialist hypertension assessment and blood pressure management with Dr Imtiaz Ali Kalyar. Sunday clinics available. Naas, Co. Kildare.

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