Hypertension is a fairly common problem in Singapore. Slightly less than 1 in 4 Singapore residents aged 30 to 69 years have hypertension. The older you are, the more likely you are to have hypertension. In the 60 - 69 years age group, more than 1 in 2 persons have hypertension.

Hypertension or high blood pressure refers to the condition in which the blood is pumped around the body at too high a pressure.

Blood Pressure (BP) is described by two numbers, for example, if your BP is 120/80, the systolic BP is 120mmHg and the diastolic BP is 80mmHg.

You have hypertension if your systolic BP is 140mmHg or more, or your diastolic BP is 90mmHg or more, or both (mmHg is millimetres of mercury , a measure of pressure).

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In 95% of cases, the cause of hypertension is unknown. In 5% of cases, hypertension may be due to causes such as kidney disease, narrowing of certain blood vessels or hormonal imbalance. Certain risk factors increase the chance of developing hypertension. These include obesity and diabetes.

Signs and Symptoms

Hypertension is often called the silent killer . This is because, even when severe, it may not give rise to any symptoms.

Occasionally, you may have headaches or giddiness when the hypertension is severe. However, these symptoms are not specfic to hypertension; they are also present in other diseases.

Sometimes, hypertension is only discovered when complications set in, for example, a stroke or heart attack.

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Hypertension increases the risk of developing atherosclerosis (hardening and narrowing of the arteries). If untreated or inadequately treated, hypertension can cause the following problems:

• Coronary heart disease
• Heart failure
• Stroke
• Peripheral artery disease (narrowing of the blood vessels of the limbs)
• Kidney failure

The risk of suffering from the complications of hypertension is increased if you:

• Are a smoker
• Suffer from diabetes
• Have high blood cholesterol
• Are overweight (BMI of 23kg/m2 or higher)

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If you are diagnosed with hypertension, your doctor will:

• Take a medical history
• Examine you
• Check for signs of complications e.g. heart failure
• Do relevant blood and urine tests
• Do a chest X-ray
• Do an ECG (electrocardiogram)

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Know Your Targets

Your doctor will help you work out your personal targets for blood glucose, blood pressure, blood cholesterol.

*BMI - refers to Body Mass Index. To get your BMI, take your weights in kg and divide it by the square of your height (in metres). Keep your BMI below 23kg/m2 but not less than 18.5kg/m2.

**LDL cholesterol - refers to 'bad' cholesterol that clogs up blood vessels, reducing blood flow to important organs.

Monitor Your Blood Pressure

Checking your blood pressure at home helps you keep a closer watch on your blood pressure and manage your hypertension better. There are many different types of home blood pressure monitors available. Your doctor will help you choose one that is best for you and advise you on how to use it.

Go for regular check-ups

Take your antihypertensive medication as prescribed by your doctor

The most commonly used drugs belong to these 5 main groups:

• Diuretics
• Beta-blockers
• Calcium channel blockers
• Angiotensin converting enzyme inhibitors
• Angiotensin II receptor blockers

Your doctor will decide which drug is most suitable for you. More than one drug may be prescribed to keep your BP at an acceptable level. Single drugs which combine medications from 2 of these groups are also available.

If you are on antihypertensive drugs, note the following:

• Treatment is life long (i.e. you have to continue with the medication), so do discuss the cost of anti-hypertensive medications with your doctor.
• Do not stop or change the dose of your medication without consulting your doctor.
• For effective BP control, make sure you see your doctor regularly to monitor your BP. You can also monitor your BP more frequently at home with an electronic BP monitor.

Remember, long term effective control of blood pressure is crucial in reducing risks of serious complications of hypertension.

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Lead a Healthy Lifestyle

Control your weight to keep your BMI less than 23kg/m2 but not below 18.5kg/m2. Reducing your excess weight will help to lower your total and LDL-cholesterol and triglyceride levels.

• Healthy diet
  • Limit your intake of all types of fats. Try to replace saturated with unsaturated fats.
  • Limit your cholesterol intake. Major sources include organ meats (e.g. liver, brains, kidney, intestines and heart), egg yolk, squid, fish roe, shellfish, prawns, crabs and animal fats.
  • Increase fibre intake. Fibre is found in oats, oat bran, barley, fruit, vegetables, legumes and whole grains can speed up the removal of cholesterol from your blood.
• Exercise for 150 minutes per week, each time at least 10 minutes. Lack of exercise is associated with a low HDL - cholesterol level.
• Limit alcohol intake to no more than 2 standard drinks per day.
• Don't smoke.

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