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NAME OF PATIENT GENDER M F

COMORBID CONDITIONS DOB IDN Cardiocascular Kidney Other Guidelines BP target DATE(YY/MM/DD) 140/90Hypertension 130/80 Diabetes 125/75 Kidney disease INITIAL REVIEW (BASELINE) Blood Pressure

E V E R Y 3 - 6 M O N T H S

B P & S E L F

M A N A G E M E N T

Smoking: Y N packs/day: Activity level (at least 30 mins, 5 days/wk) Salt intake

Alcohol consumption

Weight (target):

M E D I C A T I T O S N S / E F F E C

Diuretic (first choice):

Beta blocker

ACE/ARB

Combination

ASA (81 mg) > 10% CHD risk < 70 yrs Other:

Height/Weight Calculated BMI (< 27) A N N U A L L Y O R A S Fasting glucose A P P R O P R I A T E

T E S T S

Microalbumin (ACR) Every 2nd yr if BP < 160; Annually if > 160 systolic Lipid ratio TC/HDL

LDL-C

Triglycerides

eGFR

C L I N I C A L

Consider end - organ disease - Eyes; Heart/Circuation; Kidneys: E V A VISIT 1 L O U N A VISIT 3 T I

VISIT 2

VISIT 4