High Blood Pressure (Hypertension): A Care Staff Guide for Ireland

This guide covers Ireland. For the UK equivalent, see our guide: High Blood Pressure (Hypertension) Care Staff Guide: NICE NG136.

The HSE says high blood pressure (hypertension) "does not usually have any symptoms". For care staff, the main jobs are to make sure checks happen, to record and report readings correctly, and to help people take prescribed medicines as directed. This guide summarises what the HSE and the Irish Heart Foundation say, and where the sources stop. Medicine choices stay with the person's GP or prescriber; for the practical side of giving medicines, see our guide to medication management training for healthcare staff in Ireland.

What the HSE says about high blood pressure

According to the HSE (pages on high blood pressure last reviewed 3 January 2022, with the next review shown as due 3 January 2025), high blood pressure raises the risk of heart disease, atrial fibrillation, stroke, dementia, loss of eyesight and kidney failure. In most cases the cause is not clear. Risk factors listed include age, family history, high salt intake, inactivity, being overweight, heavy drinking, smoking, long-term sleep deprivation and obstructive sleep apnoea. In about 1 in 20 cases it results from an underlying condition or a certain medicine.

The HSE lists medicines and substances that can raise blood pressure, including the contraceptive pill, steroids, NSAIDs such as ibuprofen and naproxen, some pharmacy cough and cold remedies, some herbal remedies (particularly those containing liquorice), amphetamines, cocaine, and some SSNRI-type antidepressants. It says blood pressure may return to normal after stopping these. Our suggestion: do not stop or change a medicine on that basis; if you think a medicine may be affecting someone's readings, tell the GP or prescriber.

Who should be checked, and how often?

The HSE says adults aged 40 and over should be checked at least once a year, and healthy adults aged 18 to 39 with no family history at least once every 5 years. The Irish Heart Foundation (page last modified 9 March 2026) gives a slightly different schedule for people under 40 with no risk factors, every 3 years, and also says over-40s should be checked at least once a year. If you work with someone who has other risk factors, the Irish Heart Foundation says the more cardiovascular risk factors a person has, or if they have had a heart attack or stroke, the more urgent it is to get their pressure measured and controlled. The Irish Heart Foundation also says that under the Chronic Disease Management Programme a GP review every 12 months, with a blood pressure check and blood tests, is free with a medical card or GP visit card.

Understanding readings

Blood pressure is given as two figures in mmHg. The HSE explains that systolic is the pressure when the heart pushes blood out and diastolic is the pressure when the heart rests between beats. The HSE gives these thresholds:

• High: 140/90mmHg or higher in clinic, or an average of 135/85mmHg at home.
• High for people over 80: 150/90mmHg or higher in clinic, or an average of 145/85mmHg at home.
• Ideal: usually between 90/60mmHg and 120/80mmHg.

The Irish Heart Foundation describes normal as below 120/70, gives high blood pressure as usually 140/90 or more, and says the figure is lower for people with conditions such as diabetes, kidney disease, a past stroke or heart disease. Because the two organisations describe normal ranges differently, and because targets are individual, care staff should use the targets in the person's own care plan or set by their doctor rather than a general figure.

Both organisations say one high reading does not confirm high blood pressure. The HSE says readings fluctuate, and that a GP may ask the person to take readings at home or to wear a 24-hour ambulatory monitor.

Taking a reading properly

The HSE describes a clinic test in which the person sits with their back supported and legs uncrossed for at least 5 minutes beforehand, with the arm bare and held at heart level, supported by a cushion or chair arm, relaxed and not talking. For home monitoring the HSE says to use a properly tested monitor (it points to STRIDE-BP, which lists recommended devices), measure twice a day, morning and evening, seated, take 2 readings 1 minute apart each time, and continue for 7 days so the GP or nurse can calculate an average. Whether support staff take readings is a matter for your service's procedures and training. Our suggestion: follow the same conditions every time, write down the exact figures with date and time, and avoid rounding or re-taking readings until they look better.

Treatment: what the HSE says, and what staff should not do

The HSE says everyone with high blood pressure is advised to make healthy lifestyle changes, and that the GP decides on medicine by looking at readings and the person's risk of heart attack or stroke. Lifestyle advice includes cutting salt to under 6g a day (about one teaspoon), eating a balanced low-fat diet with plenty of fruit and vegetables, being active, cutting back on alcohol and caffeine, losing weight if needed, stopping smoking and getting at least 6 hours of sleep a night.

The HSE page names five types of medicine: ACE inhibitors, angiotensin-2 receptor blockers, calcium channel blockers, diuretics and beta blockers, and lists possible side effects for each. Examples include a persistent dry cough with ACE inhibitors, swollen ankles with calcium channel blockers, and dizziness on standing and frequent urination with diuretics. It says grapefruit juice can increase the risk of side effects with calcium channel blockers. This post gives no dosing information; that belongs with the prescriber and the pharmacist.

On adherence, the HSE says to take the medicine exactly as directed, that missed doses make it less effective, that the person may not feel different, and that this does not mean it is not working. It says that if there are side effects, the person should not stop taking the medicine but talk to the GP. The Irish Heart Foundation says the same: medication is usually lifelong, never stop without talking to your doctor, and tell the doctor about side effects so they can adjust the medicine or dose.

What care staff can observe, record and escalate

Because the HSE says there are usually no symptoms, observation alone is not a reliable way to spot high blood pressure. A practical approach, offered as our suggestion and not as a requirement:

• Know the plan: check whether the person has a diagnosis, a target range and a review date in their care plan.
• Keep records: record readings, date, time, who took them and any medicine changes.
• Report patterns: pass readings outside the documented range, and new side effects such as dizziness on standing, to the nurse, manager or GP as your service requires.
• Support appointments: help the person attend their annual review and any blood tests.
• Support lifestyle goals: salt, activity, alcohol, smoking and sleep are all named in the HSE advice.

Clear, consistent records also matter when a service is inspected; see our guide to HIQA inspections and staff training in Ireland.

The HSE high blood pressure pages do not say when to seek urgent care for a high reading, so do not rely on a general number. The HSE stroke page (last reviewed 28 June 2023) says to phone 999 or 112 immediately and ask for an ambulance if someone has drooping on one side of the face, cannot lift both arms and keep them there, or has slurred or garbled speech. Follow your service's own emergency and escalation procedures, and where a person seems unwell or you suspect neglect or poor access to care, also consider your safeguarding duties, covered in our guide to safeguarding vulnerable adults training in Ireland.

Learnsignal's offices are off Baggot Street in Dublin, and we offer in-person training from there. For current details, see our CPD pages.

Frequently asked questions

Can you tell if someone has high blood pressure from how they look or feel?

Not reliably. The HSE says it does not usually have any symptoms, and the Irish Heart Foundation says a person may look and feel well, so the only way to know is to have it checked.

Should a care worker stop a blood pressure tablet if the person has side effects?

No. The HSE says not to stop taking the medicine and to talk to the GP, who may change it. Report side effects and follow the prescriber's instructions.

What reading counts as high?

The HSE says 140/90mmHg or higher in clinic, or an average of 135/85mmHg at home, with different figures for people over 80. A single reading does not confirm the condition, and individual targets are set by the doctor.

Where can staff and residents get free blood pressure checks?

The Irish Heart Foundation says its Mobile Health Unit offers free heart health checks that travel around Ireland. The HSE lists GP surgeries, some pharmacies and some workplaces as places to be checked.

Accurate records and prompt reporting are the most useful things care staff can contribute to blood pressure care.