Article: Volume 46 Number 6 Page 508 - June 2019

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  Dent Update 2019; 46: 508-513

Medicine in Dentistry:  Hypertension – An Update for the Dental (Sedation) Team

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Abstract: 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.

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.

Author notes: Ross Leader, MB ChB(Hons), BDS(Hons), MFDS RCPS(Glasg), PgDip ClinEd(RCPSG), Foundation Doctor and Staff Grade in Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL (email: rossleader@doctors.org.uk), Tom Thayer, BChD, FDS, MA MedEd, FHEA, Consultant and Honorary Senior Lecturer in Oral Surgery, University of Liverpool Dental School, Pembroke Place, Liverpool L3 5PS, Bridget Maher, MB ChB (Commendation), MD, FRCP, Consultant in Clinical Pharmacology and General Internal Medicine, Hypertension Lead, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL and Chris Bell, MB ChB(Hons), BMus, Academic Foundation Doctor, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD, UK.

Objective: To update GDPs, including those who practise IV Midazolam sedation, on how patients who present with suspected hypertension are managed by their GMP.