Establishment of a Difficult Hypertension Clinic in Whangarei, New Zealand: the first 18 months

N Z Med J. 2008 Nov 7;121(1285):63-72.


A Difficult Hypertension Clinic was established at Whangarei Hospital (Whangarei, Northland, New Zealand) in March 2006 in response to a perceived need amongst general practitioners. The experience with the first 150 patients is reviewed. Mean BP at referral was 162/89 mmHg, and mean number of antihypertensive drugs was 2.49. Mean BP at discharge from the Difficult Hypertension Clinic was 138/78 mmHg and mean number of antihypertensive drugs 3.16. The commonest cause of hypertension resistance was underprescription of diuretics. Secondary or contributory causes of hypertension were identified in 28 (19%) of patients, and white coat hypertension in three (2%). The Difficult Hypertension Clinic established in our hospital is an effective model for achieving clinical targets and care recommended in evidence-based guidelines.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / classification*
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Family Practice / organization & administration*
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • New Zealand
  • Outpatient Clinics, Hospital / organization & administration
  • Outpatient Clinics, Hospital / statistics & numerical data*
  • Young Adult


  • Antihypertensive Agents