Neither high blood pressure nor high cholesterol makes you feel unwell, which is exactly why both are worth taking seriously. The number on its own means very little – what matters is your overall cardiovascular risk, and that is a calculation, not a guess.
What we look after
- High blood pressure – diagnosis, treatment and long-term monitoring
- High cholesterol and other lipid problems, including familial patterns that run in a family
- Absolute cardiovascular risk assessment – your actual risk of a heart attack or stroke over the next five years, calculated properly
- Prevention after a heart attack, stroke or stent, alongside your cardiologist
- The conditions that travel with these – diabetes, kidney disease, sleep apnoea, weight, atrial fibrillation
- Medication review where side effects or cost are getting in the way of taking it
Getting the diagnosis right
A single high reading in a consulting room is not high blood pressure. Around one person in five with a high reading at the practice has normal pressure at home, and treating them achieves nothing but side effects. Before starting long-term treatment we confirm it – repeated readings, a home monitoring record over a week, or 24-hour blood pressure monitoring, which is done here at the practice.
The same applies to cholesterol. One number in isolation does not decide anything. It goes into a risk calculation with your age, sex, blood pressure, smoking status, diabetes and kidney function, and it is that combined figure that determines whether treatment is worth it for you.
What gets checked
- Blood pressure – at every visit, plus home readings where that helps. General target is under 140/90, and lower where you also have diabetes or kidney disease.
- Full lipid profile – total, LDL, HDL and triglycerides.
- Kidney function and urine ACR – high blood pressure damages kidneys and kidney disease raises blood pressure; see kidney care.
- Blood glucose or HbA1c – see diabetes care.
- Absolute cardiovascular risk, recalculated as things change.
- Weight, waist and activity, with an InBody scan if you want to track composition rather than weight alone.
- Smoking and alcohol, with practical help rather than a lecture.
Pathology is on site, and so are 24-hour blood pressure monitoring, ECG and Holter monitoring. The tests that confirm the diagnosis and check the heart happen here, without a separate referral and a wait in between.
Your care plan
The way Medicare funds this changed on 1 July 2025. The old GP Management Plan and Team Care Arrangement were replaced by a single GP Chronic Condition Management Plan. If you already had a plan under the old system it still counts; it simply moves across at your next review.
What that means in practice:
- You are eligible if you have at least one condition that has lasted, or is likely to last, six months or more. There is no official list of qualifying conditions – it is your doctor’s clinical judgement.
- One plan now covers both the management plan and the referrals to other health professionals.
- The plan needs to be written or reviewed within the last 18 months for you to keep access to the rebated allied health visits.
- With a current plan you can claim up to five individual allied health visits per calendar year (ten for Aboriginal and Torres Strait Islander patients) – for example a dietitian, podiatrist, diabetes educator, physiotherapist or exercise physiologist.
- You can also have up to five services from a practice nurse on your doctor’s behalf.
- If you are registered with us through MyMedicare, your plan is written here, at the practice you are registered with. If you are not registered, your usual GP can still write it.
Care plans and their reviews are bulk billed at Health Nexus. There is no out-of-pocket cost for writing the plan or for reviewing it.
Much of the monitoring and recall work is done by the practice nursing team alongside your doctor. The nurses run the checks that are due, keep the recalls on schedule and prepare the review so that your appointment with the doctor is spent on decisions rather than data entry. It is also why the reviews actually happen – the most common reason chronic disease care fails is that the review is never booked.
What to expect
Book a long appointment. If you have a home blood pressure monitor, bring a week of readings taken morning and evening while sitting quietly – that record is worth more than anything measured in a consulting room. Bring your medicines, and be honest about any you have stopped taking and why. Cost and side effects are common reasons, and there is almost always something that can be done about both.
The doctors
All of the doctors who work from Health Nexus manage long-term conditions. Several have substantial hospital experience behind them:
- Dr John Esho – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals, including cardiology and nephrology; internal and general medicine
- Dr Arsalan (Sam) Mahmud – medical registrar in multiple specialties across northern and north-west Tasmanian hospitals; general and emergency medicine, and continues to work in acute care
- Dr Asim Razak – chronic disease, cardiovascular and respiratory conditions
- Dr Sai Tip – chronic disease, respiratory medicine
- Dr Miyulasi Attanayake – chronic disease, diabetes, hypertension, asthma and COPD
- Dr Nadia Khan – chronic disease, diabetes and hypertension
- Dr Nalika Hendawitharana – chronic disease, preventive health
Fees and Medicare
Health Nexus Launceston is a mixed-billing practice. Children aged 12 and under are bulk billed whenever the practice is open, including evenings and weekends. Pension card holders over 65 and DVA Gold Card holders are bulk billed on weekdays between 8am and 5pm. Everyone else pays the consultation fee with the Medicare rebate claimed on the spot. The current fees are on the fees and bulk billing page.
The practice is open 8am–8pm Monday to Friday, 8am–5pm Saturday and 9am–5pm Sunday, every day of the year, and on every public holiday at the standard hours for that day.
Common questions
My blood pressure is only high at the doctor. Does that count?
Often it does not. White-coat hypertension is common, which is why we confirm with home readings or 24-hour blood pressure monitoring, which we do here, before committing anyone to long-term treatment. Bring a week of home readings if you have a monitor.
What is absolute cardiovascular risk?
It is your calculated chance of a heart attack or stroke in the next five years, worked out from your age, sex, blood pressure, cholesterol, smoking status, diabetes and kidney function together. It is a far better guide to whether treatment helps you than any single number on its own.
Do I have to take tablets for the rest of my life?
Not necessarily. For some people weight, alcohol, salt, activity and sleep apnoea treatment bring blood pressure down enough to reduce or stop medication. For others the risk is high enough that treatment is the sensible choice. It is a decision made with you, and revisited.
How often should I be reviewed?
Every three to six months while things are being adjusted, then six to twelve monthly once stable, with bloods at each review.
Is the care plan bulk billed?
Yes. Care plans and their reviews are bulk billed here.
