The Department has strong ties with Trinity College Dublin with a focus on clinical education and research. The remit of the department is diverse, spanning the areas of cardiovascular disease prevention, hypertension, hyperlipidaemia, pharmacoeconomics, clinical trials, prescribing, toxicology and general internal medicine.

  • Assessment of hypertension  – young people with hypertension, difficult to treat hypertension (resistant hypertension).
  • Assessment of complex lipid disorders – familial hypercholesterolemia, primary hypertriglyceridemia.
  • General internal medicine – the department cares for patients referred to medicine via the emergency department.
  • Education and research – our patients are involved, with their permission, in the education of health professionals and clinical studies which improve practice.

  • For untreated patients with a new hypertension diagnosis, please see notes below for considerations before referral to assess for secondary hypertension.

    If a review is required, and it is safe to do so, do not commence anti-hypertensives and refer urgently for assessment.

    If treatment is required, consider an alpha blocker (doxazocin) or a calcium channel blocker (diltiazem, amlodipine) in the first instance. This avoids complications with screening blood tests.

    White coat hypertension should be out ruled by a 24 hour ambulatory blood pressure monitor or home BP readings prior to referral. Details of these results are required for referral.

    Lifestyle contributors should be screened for and addressed prior to referral: alcohol and illicit drug misuse, severe excess body weight, high salt diet.

    If secondary causes have been identified e.g. sleep disorders, kidney disease, these should be first referred to the appropriate service.

    Referrals are considered for the following patients/conditions, aligned with British and Irish Hypertension Society Guidance:

    Age <40 at diagnosis

    • Those with BP>160/100 or
    • >140/90 with high suspicion of secondary causes (without a strong family history of hypertension and/or lifestyle factors including obesity).

    Resistant hypertension

    • patient taking 3+ anti-hypertensive medications at optimal doses including a diuretic,
    • BP >130/80 on an ambulatory blood pressure monitor (ABPM),
    • Non-adherence is out ruled as far as possible.

    Suspected secondary hypertension

    • Spontaneous or drug-induced hypokalaemia.
    • Hypertensive first degree relative of patient with primary aldosteronism.
    • Symptoms of a pheochromocytoma.

    Hypertension in pregnancy not resolving post-partum (>6 weeks after delivery)

    Intolerance to multiple anti-hypertensive medications with uncontrolled BP and complex polypharmacy in the setting of hypertension

    Those with malignant hypertension or a hypertensive crisis should be referred to their local emergency department.

    Please include the following details in the referral:

    • Reason for referral
    • Current medication
    • Previous intolerance to specific antihypertensive drugs with reasons
    • Relevant medical history and family history
    • Duration of hypertension / age at diagnosis
    • Blood and urine test results (renal, liver, lipid profiles, thyroid function, HbA1c)
    • Ambulatory and/or home blood pressure monitoring results
    • ECG
    • Echocardiography, imaging reports (e.g. renal ultrasound, CT or MRI) if available.

  • The Hypertension clinic is held weekly on Wednesday mornings.

    You may be asked to attend for an initial assessment with our nursing or healthcare staff before attending the clinic. This is the first consultation occurs with all available information to provide an efficient review.

    Please bring the following items with you to your appointment:

    • A complete list of the medications you are currently taking.
    • Any relevant information on tests and procedures completed in other hospitals. Recent blood test results should be emailed to barmedsec@stjames.ie and/or a paper copy with you to your appointment.

  • Dr Patricia O’Connor – Lipid Clinic

    Dr Cormac Kennedy – Hypertension Clinic

    Professor Michael Barry

    Professor Martina Hennessy

    Dr John Stinson

    Ms Orlaith McNulty (01 416 2883)

    Ms Deirdre Lee (01 416 2291)

Contact Details
barmedsec@stjames.ie
(01) 416 2291
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