No symptoms, real consequences. Home readings make this one of the best conditions to manage remotely.
Assessed and prescribed by a GMC-registered GP
Prescriptions sent electronically to a pharmacy
Monitoring and follow-up included where it is needed
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
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Registered with the Care Quality Commission
High blood pressure causes no symptoms and considerable harm. It is the single largest modifiable risk factor for stroke, and around a third of UK adults with it do not know they have it.
It is also, unusually, a condition well suited to remote care: the measurement that matters most is the one you take at home, not the one taken in a clinic room while you are mildly anxious about being in a clinic room.
Four main drug classes, chosen by age and ethnicity as well as by reading:
Most people eventually need two drugs at moderate doses rather than one at maximum dose — fewer side effects, better control.
We ask for readings twice daily for 7 days on a validated upper-arm monitor. This is the correct way to diagnose and is more informative than any single reading we could take.
Full history including salt, alcohol, sleep, NSAIDs, decongestants and the combined pill — all of which raise blood pressure and all of which are commonly overlooked.
Kidney function, electrolytes, HbA1c, lipids and urine testing for protein. Under 40 with high blood pressure, we look harder for a secondary cause.
Bloods are repeated within 2–4 weeks of starting an ACE inhibitor or ARB. Dose is titrated against your home readings.
ACE inhibitors cause a dry, persistent cough in around 1 in 10 people. It is not dangerous, it does not respond to cough remedies, and it resolves on switching to an ARB — a switch that is often delayed for months.
Amlodipine commonly causes ankle swelling, which is dose-related and often improves when combined with an ACE inhibitor rather than used alone at high dose.
Diuretics can lower sodium and potassium and raise urate, occasionally triggering gout.
Dizziness on standing is common when starting or increasing a dose. Get up slowly; tell us if it persists.
ACE inhibitors and ARBs can affect kidney function, which is why bloods are repeated after starting.
A reading of 180/120 or above with headache, chest pain, breathlessness, visual disturbance or weakness needs emergency assessment, not an online consultation.
Twice daily for seven days on a validated upper-arm monitor, morning and evening, sitting quietly for five minutes first, arm supported at heart level. Discard day one and average the rest.
Generally below 135/85 on home readings for most adults under 80, and below 145/85 over 80. Lower targets apply with diabetes, kidney disease or established cardiovascular disease — the number is individual rather than universal.
Fewer side effects, better control. Needing a second drug is not a failure and not a sign things are worsening — it is how blood pressure is normally treated.
A reading of 180/120 or above with headache, chest pain, breathlessness, visual disturbance, or weakness on one side needs emergency assessment, not an online consultation.
Blood pressure medication controls rather than cures — it returns when treatment stops. Beta blockers in particular must never be stopped abruptly, which can cause a dangerous rebound.
Tell us immediately if you are pregnant or planning pregnancy. ACE inhibitors and ARBs must be stopped, and pregnancy-safe alternatives used instead.
These are not token advice — several produce reductions comparable to a low-dose medicine.
A medication review is free and sometimes resolves the problem entirely.
Choice is guided by age and ethnicity as well as by the reading: ACE inhibitors and ARBs first-line under 55; calcium channel blockers first-line over 55, and at any age for people of Black African or Caribbean heritage, in whom ACE inhibitors work less well and cause cough more often.
If one drug does not suit you, another will. There is no single right medicine, and switching is normal.
High blood pressure in a younger person warrants looking harder for a secondary cause — kidney disease, hormonal conditions, coarctation, sleep apnoea. That is a different assessment from simply starting treatment.
High blood pressure is treated free on the NHS with structured annual review, and prescriptions are free in Scotland, Wales and Northern Ireland. If you are registered, that is usually the better-integrated route, and we will say so.
Supplements marketed for blood pressure, wrist monitors, and checking your reading repeatedly through the day, which produces anxiety and numbers nobody can act on.
Blood pressure medicines are among the cheapest prescriptions in existence. Amlodipine, ramipril, losartan and indapamide are all inexpensive generics.
We earn nothing from what is prescribed.
A validated upper-arm blood pressure monitor. Modest cost, and it is the single most useful purchase for anyone with high blood pressure — home readings are more informative than anything measured in a clinic room.
Check it appears on the British and Irish Hypertension Society validated list, and buy the right cuff size. Do not buy a wrist monitor, whatever the packaging says.
High blood pressure is treated free on the NHS with structured annual review, and it is a long-term condition. If you are registered with a GP, that route is cheaper and better joined-up over years.
Where we are genuinely useful: speed when you cannot get an appointment; twenty minutes to go through home readings and cardiovascular risk properly; and a proper review for someone who has been on a repeat prescription for years without one.
Untreated high blood pressure is the single largest modifiable risk factor for stroke. Whatever this costs is trivial against that.
If cost is stopping you taking treatment, say so. Prepayment certificates in England, and free prescriptions elsewhere in the UK, mean there is usually an answer.
No supplements, no monitors, no packages. We sell nothing — and no supplement marketed for blood pressure has evidence approaching that for a £2-a-month generic tablet.
Because home readings are the better measurement, and because we cannot take yours remotely.
Clinic readings are raised in a substantial proportion of people simply by being in a clinic — white-coat effect is real and leads to unnecessary treatment. Home readings over a week are more informative than any single reading anyone could take.
This is one of the few conditions where remote care is genuinely better rather than merely equivalent.
Twice daily for seven days. Sit quietly for five minutes first, back supported, feet flat, arm supported at heart level. Two readings a minute apart each time.
Discard day one and average the rest. Use an upper-arm monitor from the validated list, with the correct cuff size — a cuff that is too small gives falsely high readings.
Generally below 135/85 at home for most adults under 80, and below 145/85 over 80. Lower targets apply with diabetes, kidney disease or existing cardiovascular disease.
Usually, and it is better framed as control than as cure. Blood pressure rises again when treatment stops.
Some people do come off treatment after substantial weight loss, stopping drinking, or treating sleep apnoea. That is a planned decision with monitoring, not something to try alone.
Very likely — ACE inhibitors cause it in around 1 in 10 people. It is not dangerous, and it does not respond to cough remedies.
It resolves on switching to an ARB, which is a simple change. People put up with this for months before mentioning it, which is unnecessary — tell us.
Common and dose-related. It often improves when a second drug is added rather than the amlodipine dose being pushed higher — which is one reason two medicines at moderate doses usually beat one at maximum.
No — it is how blood pressure is normally treated. Two drugs at moderate doses give better control with fewer side effects than one at maximum dose.
Most people eventually need two. It is not an escalation and not a failure.
Sometimes, and it is always worth trying alongside. Salt, alcohol, weight, exercise and sleep all matter measurably — and isometric exercise such as wall squats has surprisingly strong evidence.
Also check what is raising it: regular ibuprofen, decongestants, the combined pill, steroids, and liquorice in quantity.
180/120 or above with headache, chest pain, breathlessness, visual disturbance, or weakness on one side — that is emergency assessment, not an online appointment.
A single high reading without symptoms is usually not an emergency. Sit quietly, repeat it after five minutes, and do not spiral into repeated checking.
Almost never, which is the whole problem. Headaches and nosebleeds are not reliable signs, and people treat by how they feel and stop when they feel fine.
Around a third of UK adults with high blood pressure do not know they have it.
Substantially, and tell us immediately. ACE inhibitors and ARBs must be stopped — they can harm a developing baby — and pregnancy-safe alternatives used instead.
Blood pressure in pregnancy needs maternity team involvement rather than remote management alone.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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