Hypertension – Update from ESC HTN Guidelines 2024

Hypertension – Update from ESC HTN Guidelines 2024

Participants * Dr David McConaghy, Irish College of GPs Clinical Lead in Prevention; Member of HSE Team on Integrated Care Programme for Chronic Disease * Dr John Maher - Host Summary * This conversation reviews the management of hypertension in primary care, in light of recently-published ESC 2024 guidelines. We discuss: * updated blood pressure targets and the potential implications for blood pressure diagnosis and management in primary care; * the shift towards first-line combination therapy, for potentially improved patient outcomes; * the role of risk assessment tools such as QRISK3 to guide management; * the importance of lifestyle changes. We also highlight the role of ECG and ABPM monitoring, and criteria for referring patients to secondary care, emphasising a proactive approach to management  of hypertension, to reduce morbidity and mortality.   Takeaways * Hypertension is a leading cause of morbidity and mortality. * The new target for blood pressure is under 130/80 mmHg. * Elevated blood pressure is now defined as 120/70 mmHg. * Combination therapy is preferred over monotherapy for hypertension. * Audits can improve hypertension management in general practice. * Lifestyle changes are essential for managing hypertension. * QRISK3 is a useful tool for cardiovascular risk assessment. * Annual ECG and ABPM are recommended for patients with established hypertension. * Referral to secondary care is necessary for resistant hypertension. * Proactive management can significantly reduce cardiovascular events. Links 1.    Guidelines for the management of elevated blood pressure and hypertension 2024 - European Society of Cardiology [https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension] 2.    Primary prevention of cardiovascular disease in primary care - Forum September 2025, Irish College of GPs [https://www.irishcollegeofgps.ie/Forum/journal-articles?JournalID=367] 3.    HSE Opportunistic case finding - 1st Report [https://about.hse.ie/publications/opportunistic-case-finding-programme/] 4.    Structured Chronic Disease Management Treatment Programme - 3rd Report [https://www.lenus.ie/server/api/core/bitstreams/8d83b46d-3d4b-4c96-9f95-1de0e09baaf8/content] 5.    QRISK3 Online Calculator [https://qrisk.org/] 6.    SCORE2 Online Calculator (MDCalc) [https://www.mdcalc.com/calc/10499/systematic-coronary-risk-evaluation-score2] Disclaimer The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional. The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs. Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast. This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability. While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented. By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided. Subscribe, like and review wherever you get your podcasts. Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast [https://www.irishcollegeofgps.ie/The-GP-Podcast] Email: podcast@icgp.ie

Early Medical Abortion (EMA) in Primary Care - Part 2

Participants Dr Ciara McCarthy - GP Lead in Women's Health, HSE and Irish College of GPs Dr Laura Cullen - Director of Women's Health, Irish College of GPs Dr John Maher - Host   Summary This two-part conversation reviews the provision of Early Medical Abortion (EMA) in primary care Ireland, based on the Irish College of GPs Quick Reference Guide "Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners" which is available on the College website.  We will refer to this QRG throughout our conversation.   In today’s episode, which is part two, Ciara and Laura continue their discussion, covering topics including: * the notification aspect of the legislation in Ireland; * management of complications, including in the Out of Hours setting; * an approach to the patient expressing ambivalence; * contraception considerations; * training offered by the Irish College of GPs to support GPs who wish to provide an EMA service; * practice considerations and tips for setting up an EMA service. Links to Core Irish College of GP Resources referenced during episode •     QRG: Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=mWqWIMeatvU=&portalid=0] •     QRG: Clinical Support for Termination of Pregnancy in General Practice [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=7wtXdp88Cb8=&portalid=0] •     Checklist for. GPs preparing to provide a termination of pregnancy service - Appendix 2 of QRG [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=7wtXdp88Cb8=&portalid=0] •     Digital Blended Learning: Early Medical Abortion [https://www.icgpeducation.ie/course/view.php?id=362]   Links to Other Useful Resources Mentioned •     Health (Regulation of Termination of Pregnancy) Act 2018 [https://www.irishstatutebook.ie/eli/2018/act/31/enacted/en/html] •     Irish Medical Council Guide to Professional Conduct & Ethics for Registered Medical Practitioners - 9th Edition 2024 [https://www.medicalcouncil.ie/news-and-publications/publications/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-2024.pdf] •     HSE Unplanned Pregnancy Supports (Including My Options) [https://www2.hse.ie/services/unplanned-pregnancy/] Disclaimer The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional. The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs. Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast. This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability. While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented. By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided. Subscribe, like and review wherever you get your podcasts. Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast [https://www.irishcollegeofgps.ie/The-GP-Podcast] Email: podcast@icgp.ie

Early Medical Abortion (EMA) in Primary Care - Part 1

Participants Dr Ciara McCarthy - GP Lead in Women's Health, HSE and Irish College of GPs Dr Laura Cullen - Director of Women's Health, Irish College of GPs Dr John Maher - Host   Summary This two-part conversation reviews the provision of Early Medical Abortion (EMA) in primary care Ireland, based on the Irish College of GPs Quick Reference Guide "Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners" which is available on the College website.  We will refer to this QRG throughout our conversation.   In today’s episode, which is part one, Ciara and Laura discuss the legal and ethical framework of EMA provision in primary care in Ireland, resources available through My Options, the three-visit structure in primary care and what takes place at each step, an overview of medications administered, safety, efficacy and follow-up, and the importance of providing care in a patient-centred manner, including considerations for patients living in more remote locations.   Links to Core Irish College of GP Resources referenced during episode •   QRG: Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=mWqWIMeatvU=&portalid=0] •   QRG: Clinical Support for Termination of Pregnancy in General Practice [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=7wtXdp88Cb8=&portalid=0] •   Checklist for. GPs preparing to provide a termination of pregnancy service - Appendix 2 of QRG [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=7wtXdp88Cb8=&portalid=0] •   Digital Blended Learning: Early Medical Abortion [https://www.icgpeducation.ie/course/view.php?id=362]   Links to Other Useful Resources Mentioned •  Health (Regulation of Termination of Pregnancy) Act 2018 [https://www.irishstatutebook.ie/eli/2018/act/31/enacted/en/html] •  Irish Medical Council Guide to Professional Conduct & Ethics for Registered Medical Practitioners - 9th Edition 2024 [https://www.medicalcouncil.ie/news-and-publications/publications/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-2024.pdf] •  HSE Unplanned Pregnancy Supports (Including My Options) [https://www2.hse.ie/services/unplanned-pregnancy/] Disclaimer The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional. The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs. Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast. This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability. While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented. By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided. Subscribe, like and review wherever you get your podcasts. Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast [https://www.irishcollegeofgps.ie/The-GP-Podcast] Email: podcast@icgp.ie

Wednesday Webinar Preview: 03 June 2026

Participants  * Dr Suzanne Kelly, Deputy Medical Director, Irish College of GPs * Dr John Maher - Host  Summary Suzanne previews tonight's Wednesday Webinar (03 June 2026).  You will find a link to the College webinar recordings page here [https://www.icgpeducation.ie/course/view.php?id=355].  This will include a recording of this month's webinar, once it becomes available in the coming days. Suzanne also discusses the new PCS cycle, the value of the PCS practice development plan at this time of year, and the role of College in providing courses to GPs that address the learning needs of clinicians in practice at every stage of their career. Please note that this is the last episode before our summer break.  We plan to return with another series in September.   In the meantime, we’ll re-release some of the early episodes that you may have missed first time around, on a fortnightly basis, to reflect the academic downtime many GPs look forward to at this time of year.   Many thanks for listening, rating and reviewing, and stay tuned for Series 2 in September! Wednesday Webinar Topics and Speakers - 03 June 2026: * Introduction - Dr Diarmuid Quinlan, Medical Director, Irish College of GPs * HIV PrEP and doxyPEP - Updates (Prof Fiona Lyons, Clinical Lead, HSE Sexual Health Programme) * Photoprotection (Dr Siobhan Twohig, GP at Thomond Park Clinic, Limerick) * Preventing Dementia: The 14-Point Checklist and the Shingles Shot (Prof Tony Foley, Dept of General Practice, University College Cork; GP in Kinsale) * Vignette: Runner's Knee (Dr Billy Twomey, GP in Dublin) Links * Irish College of GPs - Podcast Page [https://www.irishcollegeofgps.ie/The-GP-Podcast] * Wednesday Webinar Page (Including Links to Recordings) [https://www.icgpeducation.ie/course/view.php?id=355] * Forum Journal - Distance Learning MCQs [https://www.icgpeducation.ie/course/index.php?categoryid=2] * Adult Sepsis in GP - eLearning Module for members, trainees and PCS non-members [https://www.icgpeducation.ie/course/view.php?id=467] * Dermatology in Practice Certificate [https://www.irishcollegeofgps.ie/Home/Lifelong-Learning-PCS/Courses-Conferences/Courses/Modular-Courses/Dermatology-in-Practice-Certificate] * Certificate in MSK: Musculoskeletal Management & Imaging [https://www.irishcollegeofgps.ie/Home/Lifelong-Learning-PCS/Courses-Conferences/Courses/Modular-Courses/Musculoskeletal-Management-Imaging] * St James's Hospital GUIDE Clinic Links to Useful Resources for HCPs [http://guideclinic.ie/hcp/useful-links] * HSEland - PrEP Course [https://www.hseland.ie/dash/Account/PreLogin] * ExWell Medical Referral Web Page [https://www.exwell.ie/referring-a-participant] * Irish College of GPs: Routes to Membership [https://www.irishcollegeofgps.ie/Home/Explore-the-College/Membership-Networks/Membership/Routes-to-Membership] Disclaimer The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional. The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs. Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast. This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability. While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented. By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided. Subscribe, like and review wherever you get your podcasts. Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast [https://www.irishcollegeofgps.ie/The-GP-Podcast] Email: podcast@icgp.ie

Therapeutics in Primary Care: Asthma Part 2

Participants * Dr Paul Ryan, Therapeutics Clinical Lead, Irish College of GPs * Dr John Maher - Host Summary Dr John Maher is joined by Dr. Paul Ryan to resume their discussion of  Asthma Management in General Practice (this is part 2 of 2).   Today, Paul discusses: * Current guidelines and recommendations, including the 2024 Joint Guideline from the British Thoracic Society, NICE and SIGN; * The five steps in managing asthma in primary care, incorporating AIR (Anti-Inflammatory Reliever) and MART (Maintenance And Reliever Therapy) devices; * Uncontrolled asthma and managing acute exacerbations, including younger cohorts; * Considering future risk of acute exacerbations. Links * Irish College of GPs Website [https://www.irishcollegeofgps.ie/] * Respiratory Clinical Hub [https://www.irishcollegeofgps.ie/Home/Clinical-Hub/Clinical-Topics/Respiratory] * Asthma – Diagnosis, Assessment and Management in General Practice Quick Reference Guide (Dr Dermot Nolan, Dr Des Murphy, Irish College of GPs, Nov 2020) [https://www.isha.ie/sites/www.isha.ie/files/article_downloadable_resources/Asthma_-_Diagnosis__Assessment_and_Management_in_General_Practice_QRG.pdf] * BTS/NICE/SIGN Joint Guideline on Asthma: Diagnosis, Monitoring and Chronic Asthma Management (BTS/NICE/SIGN, 2024) [https://www.brit-thoracic.org.uk/clinical-resources/guidelines/asthma-chronic/] * HSE “Treat Your Respiratory Tract Infection” Patient Information Leaflet [https://assets.hse.ie/media/documents/Treat_your_Respiratory_Tract_Infection_leaflet.pdf] * Irish College of GPs Audit Toolkit (Dr Claire Collins, Irish College of GPs, 2019) [https://www.irishcollegeofgps.ie/LinkClick.aspx?fileticket=BT6MMRVWPiM%3D&portalid=0] – See Appendix 1: Audit Examples - Example 3 for Asthma  * Asthma Control Test [https://www.asthmacontroltest.com/welcome/] * Asthma Action Plan (Asthma Society of Ireland) [https://www.asthma.ie/about-asthma/managing-your-asthma/asthma-action-plan/] * Asthma Inhaler Technique Videos for Patients (Asthma Society of Ireland) [https://www.asthma.ie/resources-and-tips-type/asthma-inhaler-technique/] Disclaimer The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional. The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs. Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast. This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability. While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented. By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided. Subscribe, like and review wherever you get your podcasts. Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast [https://www.irishcollegeofgps.ie/The-GP-Podcast] Email: podcast@icgp.ie