Cardiology · Naas, Co. Kildare
Specialist assessment for high blood pressure, resistant hypertension and secondary causes. Ambulatory monitoring, cardiovascular risk stratification and personalised management plans.
Overview
Dr Imtiaz Kalyar, Consultant Interventional Cardiologist at Naas Cardiology & Endocrinology Clinic in Naas, Co. Kildare (IMC 102093), provides specialist assessment and treatment of this condition. Appointments are available on Saturdays and Sundays at Suite 5, Vista Primary Care Clinic, Ballymore Road, Naas. To book, call 089 656 7597.
Hypertension — persistently elevated blood pressure — is one of the most significant modifiable risk factors for cardiovascular disease, stroke and chronic kidney disease. Despite its prevalence, hypertension is frequently undertreated, partly because it causes no symptoms until complications arise, earning it the name "the silent killer."
Blood pressure is classified by guidelines into stages. Stage 1 hypertension is typically defined as sustained readings of 140–159 mmHg systolic or 90–99 mmHg diastolic. Stage 2 hypertension refers to readings consistently at or above 160/100 mmHg. Hypertensive urgency and emergency involve very high readings with associated symptoms or end-organ damage and require immediate medical attention.
The majority of cases represent essential (primary) hypertension — elevated blood pressure without an identifiable secondary cause. However, in a meaningful proportion of patients, particularly younger individuals and those with resistant hypertension, a secondary cause such as renal artery stenosis, primary hyperaldosteronism or sleep apnoea may be present and is treatable.
The following thresholds are used to classify blood pressure in adults according to current European (ESH/ESC) and international guidelines:
| Category | Systolic (mmHg) | Diastolic (mmHg) | Clinical Action |
|---|---|---|---|
| Optimal | < 120 | < 80 | No intervention; maintain healthy lifestyle |
| Normal | 120–129 | 80–84 | Lifestyle advice; annual monitoring |
| High Normal | 130–139 | 85–89 | Lifestyle modification; monitor closely |
| Stage 1 Hypertension | 140–159 | 90–99 | Confirm with ABPM; consider medication if CV risk elevated |
| Stage 2 Hypertension | 160–179 | 100–109 | Antihypertensive treatment recommended |
| Stage 3 Hypertension | ≥ 180 | ≥ 110 | Immediate treatment; rule out secondary cause |
| Hypertensive Emergency | > 180 | > 120 | Attend Emergency Department immediately; call 999 |
This page is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999 or 112.
Hypertensive emergency: A very high blood pressure reading (typically above 180/120 mmHg) associated with symptoms such as severe headache, visual disturbance, chest pain or breathlessness constitutes a hypertensive emergency. Please attend an Emergency Department immediately or call 999.
Accounts for 90–95% of cases. Caused by a combination of genetic predisposition and lifestyle factors including diet, physical inactivity, excess weight and stress.
An identifiable cause is present in 5–10% of cases. Causes include renovascular disease, primary aldosteronism, thyroid disorders and obstructive sleep apnoea.
Specialist Assessment
Resistant hypertension is defined as blood pressure that remains above target despite the use of three or more antihypertensive agents at optimal doses, including a diuretic. A specialist assessment in this setting is essential to exclude pseudo-resistance (poor adherence, white-coat effect), identify secondary causes and optimise therapy.
ABPM records blood pressure automatically at regular intervals over 24 hours during normal daily activities and sleep. It is the gold standard for diagnosing hypertension and identifying white-coat hypertension, masked hypertension and nocturnal dipping patterns.
Hypertension causes damage to the heart, kidneys and blood vessels over time. ECG (for left ventricular hypertrophy), echocardiogram, and renal function tests help quantify this damage and guide management intensity.
Where clinically indicated, targeted investigations for secondary hypertension including aldosterone-to-renin ratio, renal imaging and thyroid function are arranged to identify reversible causes.
Lifestyle modifications (dietary sodium reduction, increased physical activity, weight loss and alcohol reduction) are fundamental. Pharmacological therapy is tailored to individual co-morbidities and tolerability, following evidence-based guidelines.
Cardiovascular Risk
Blood pressure does not exist in isolation. Dr Kalyar performs a comprehensive cardiovascular risk assessment to understand the full context of your blood pressure in relation to your other risk factors — cholesterol, blood glucose, smoking status, family history and age — and uses validated risk scoring tools to guide treatment intensity and targets.
European risk scoring tools calculate your 10-year risk of a fatal or non-fatal cardiovascular event. This guides treatment thresholds and targets for blood pressure and other risk factors.
Full lipid profile, fasting glucose or HbA1c, renal function, electrolytes and urine protein help quantify risk and assess for hypertension-related end-organ damage.
Identifies left ventricular hypertrophy and diastolic dysfunction — important markers of hypertensive heart disease that influence prognosis and treatment decisions.
Common Questions
Specialist hypertension assessment and blood pressure management with Dr Imtiaz Ali Kalyar. Saturday & Sunday & Sunday clinics available. Naas, Co. Kildare.
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