Supplemental Material
Table of Contents
1. Educational flow diagram for anaesthetists, ward doctors and nursing staff 2 2. Educational pamphlet for patients diagnosed with hypertension...3
3. Letter for local primary health care facility for patients diagnosed with hypertension ...5
4. Educational pamphlet for patients with blood pressure in the borderline range 6
5. Letter for local primary health care facility for patients diagnosed with hypertension
...7
1. Educational flow diagram for anaesthetists, ward doctors and nursing staff
2. Educational pamphlet for patients diagnosed with hypertension
Dear Patient
During your time in hospital, you were found to have high blood pressure. This is a condition called Hypertension. The doctor has started you on some medication and performed some tests. To answer any questions you may have, please read the points below:
What is blood pressure?
Blood pressure refers to the pressure that blood applies to the inner walls of the arteries. Arteries carry blood from the heart to other organs and parts of the body.
Do I have high blood pressure?
Yes. You were diagnosed as having hypertension by the doctor before you went for your operation. There are not usually any symptoms of high blood pressure.
Is it serious?
Hypertension is a lifelong condition which needs to be treated and managed. If it is not treated properly, the high blood pressure increases the strain on your heart and arteries, eventually causing organ damage. It can increase your risk of having heart failure, a heart attack, stroke and kidney failure.
Is there a cure?
There is no cure for high blood pressure, but it can be managed well with medication that you need to take every day, and by making some changes to your lifestyle. A medicine to lower your blood pressure will be given to you by a doctor or nurse. You need to make sure you take the medicine every day and follow up at your local clinic or hospital regularly, so that you always have a supply of your pills and the doctors and nurses can measure your blood pressure and make sure it is under control.
How can I help myself?
There is a lot you can do yourself to help improve your blood pressure:
Stop smoking
Reduce the amount of salt in your diet
Avoid drinking too much alcohol
Lose weight if you are overweight or obese
Eat more fruit and vegetables
Eat more fibre
Eat more fish
Exercise at least 30 minutes per day, most days of the week
Drink less caffeine (less than 2 cups of coffee per day)
What are the side effects from antihypertensive medication?
Most of these are mild and may go away over time. Some common side effects of high blood pressure medicines include:
• Cough
• Diarrhoea or constipation
• Dizziness or lightheadedness
• Erection problems
• Feeling nervous
• Feeling tired, weak, drowsy, or a lack of energy
• Headache
• Nausea or vomiting
• Skin rash
• Weight loss or gain without trying
Tell your doctor or nurse as soon as possible if you have side effects or if the side effects are causing you problems. Most of the time, making changes to the dose of medicine or when you take it can help reduce side effects.
Never change the dose or stop taking a medicine on your own. Always talk to your doctor or nurse first.
Where to get more information:
Ask your doctor or nurse
The following websites are useful:
o
www.uptodate.com/patientso www.cdc.gov/dhdsp/index.htm o www.americanheart.org o www.nhlbi.nih.gov
Please take the letter that the doctors gave to you, to your next appointment at a Clinic or Hospital, to ensure that you continue to receive the correct management, and so that your blood pressure will continue to be controlled.
3. Letter for local primary health care facility for patients diagnosed with hypertension
Dear Patient
Please present this letter to your follow up clinic at your first visit:
To Whom It May Concern:
This patient was diagnosed with hypertension as part of a perioperative quality improvement project involving the following hospitals: Groote Schuur-, George-, Mitchells Plain District-, New Somerset-, Paarl-, Victoria-, and Worcester Provincial Hospital.
He/she has commenced taking the following medication:
Please continue this medication and measure the patient’s blood pressure according to your normal protocol at their follow up visits.
These are the results of the latest investigations:
a. Sodium: Potassium: Creatinine:
b. Fasting blood glucose level OR HbA1C:
2. ECG:
3. Cholesterol/lipogram:
4. Urine dipstix:
Thank you for your assistance in continuing the management of this patient’s hypertension!
4. Educational pamphlet for patients with blood pressure in the borderline range
Dear Patient
During your time in hospital, you were found to have blood pressure that is higher than normal. Your blood pressure was not high enough to start you on treatment, but it should be checked regularly at your local clinic. To answer any questions you may have, please read the points below:
What is blood pressure?
Blood pressure refers to the pressure that blood applies to the inner walls of the arteries. Arteries carry blood from the heart to other organs and parts of the body.
Is it serious?
Hypertension is a lifelong condition which needs to be treated and managed. If it is not treated properly, the high blood pressure increases the strain on your heart and arteries, eventually causing organ damage. It can increase your risk of having heart failure, a heart attack, stroke and kidney failure. If your blood pressure is not high enough for treatment, it is recommended that you make some changes to your lifestyle and have it checked regularly at your local clinic.
Is there a cure?
There is no cure for high blood pressure, but it can be managed well with medication that you need to take every day, and by making some changes to your lifestyle. You need to make sure you and follow up at your local clinic or hospital regularly, so that the doctors and nurses can measure your blood pressure and make sure it is under control.
How can I help myself?
There is a lot you can do yourself to help improve your blood pressure:
Stop smoking
Reduce the amount of salt in your diet
Avoid drinking too much alcohol
Lose weight if you are overweight or obese
Eat more fruit and vegetables
Eat more fibre
Eat more fish
Exercise at least 30 minutes per day, most days of the week
Drink less caffeine (less than 2 cups of coffee per day)
Where to get more information:
Ask your doctor or nurse
The following websites are useful:
o
www.uptodate.com/patientso www.cdc.gov/dhdsp/index.htm o www.americanheart.org o www.nhlbi.nih.gov
Please take the letter that the doctors gave to you, to your next appointment at a Clinic or Hospital, to ensure that you continue to receive the correct management, and so that your blood pressure will continue to be controlled.
5. Letter for local primary health care facility for patients diagnosed with hypertension
Dear Patient
Please present this letter to your follow up clinic at your first visit:
To Whom It May Concern:
This patient was diagnosed with borderline hypertension as part of a perioperative quality improvement project involving the following hospitals: Groote Schuur-, George-, Mitchells Plain District-, New Somerset-, Paarl-, Victoria-, and Worcester Provincial Hospital.
Please will you measure their blood pressure again and ensure it is within the normal range. Should it be normal, please follow up as per your protocol. Should it be raised, please initiate
antihypertensive treatment as per your institution’s practices.
Thank you for your assistance in continuing the management of this patient’s hypertension.
