Article contributed by Dr Kenneth Koh, Medical Director of OneCare Medical Group
Dr. Kenneth Koh is the Co-founder and Medical Director of OneCare Medical Group. An accredited Family Physician with the College of Family Physicians, Singapore with intensive training and experience in the UK and Singapore, Dr Koh has overseen the growth of OneCare Medical to a network of 23 clinics providing primary healthcare services island wide. OneCare Medical’s services include health screening services, vaccinations, and medical advice for all chronic and acute conditions. In December 2020, OneCare Medical and Ninkatec joined hands to launch care services for patients at home. The partnership combines Ninkatec’s advantage in medical technology with OneCare’s strength in providing preventive, accessible and professional healthcare, allowing quality service with flexibility of choice for patients as the end-user.
In this article, Dr. Kenneth Koh shares with us the essential knowledge of hypertension, or high blood pressure, including what causes high blood pressure, symptoms, diagnosis and treatment of high blood pressure and how to effectively manage it at home.
What is Hypertension? How is Hypertension Diagnosed?
Hypertension, or high blood pressure, is a chronic condition in which the blood pressure against the blood vessel is consistently high.
Generally, your blood pressure (BP in short) is indicated as Systolic Blood Pressure / Diastolic Blood Pressure, and measured in units of millimetres of mercury (mmHg). Systolic BP measures pressure when your heart beats to pump blood into the blood vessels and Diastolic BP measures pressure in between beats when the heart is relaxed. Both measurements are important, but systolic BP is sometimes more indicative of cardiovascular disease risk in adults aged 50 and above.
For example, a reading of 120/80 means blood pressure when the heart beat is 120mmHg and blood pressure between beats when the heart relaxes is 80 mmHg, and is considered in the normal range.
If your reading is consistently 140/90 or higher over time, you have hypertension. The key word here is “consistent”, as a variety of factors such as exercise, stress, lack of sleep, coffee, alcohol or certain medications can cause blood pressure to elevate temporarily. Doctors will need to take several readings to confirm a hypertension diagnosis.
Hypertension can be diagnosed as:
- Prehypertension (borderline): BP of 131-139 / 80-89
- Stage 1 hypertension: BP of 140-159 / 90-99
- Stage 2 hypertension: BP of 160 and above /100 and above
What are the Signs and Symptoms of Hypertension?
High blood pressure has rare noticeable symptoms even in serious cases. In Singapore, almost half of those suffering from hypertension are unaware of it. The condition may be discovered during complications like stroke or heart attack. Severe cases may, but not always, show symptoms such as dizziness, difficulty in breathing, nosebleed and headache (known as hypertension headache). Another problem is that these symptoms are present in many other diseases and not hypertension specific, making detection more difficult.
Left undetected and untreated, high blood pressure can result in long-term health issues such as heart diseases including heart attack and heart failure, stroke, kidney failure and even dementia if it is not detected and treated timely. For this reason, hypertension is often referred to as the ‘silent killer’. It is important to be aware of your hypertension risk and check blood pressure regularly in order to detect this chronic condition early.
Use these additional tips to measure your blood pressure accurately.
Why is Hypertension Dangerous among Elders?
In Singapore hypertension is a prevalent problem. One study reported that up to 74.1% of those aged 60 and above in Singapore have high blood pressure. Hypertension is dangerous among elderly individuals because research has also shown that the risk of high blood pressure increases with age. The older you get, the stiffer your arteries are likely to become, requiring the heart to beat harder to supply blood to your body. This results in high blood pressure. Senior adults are also at higher risk of hypertension complications and have more challenges recovering from them, due to their age.
What are the Causes and Risk Factors of Hypertension?
There are 2 types of hypertension. In most cases, the cause of high blood pressure is unknown. This type of hypertension is called essential hypertension or primary hypertension. In other cases, high blood pressure is caused by hormonal imbalance, narrowing of certain vessels, kidney diseases, or the use of certain drugs; this type is called secondary hypertension.
Though we might not know the exact causes of all hypertension cases, researchers have found several risk factors that are directly linked to hypertension, including your lifestyle, family history, and your health conditions as well as genetics, and age. Certain medical conditions such as diabetes, obesity can increase the chances of high blood pressure. Here are a number of common risk factors for high blood pressure.
Research has confirmed a strong linkage between obesity and hypertension. Simply understood, obesity means excess body fat, and having excess weight means that your heart needs to work harder to pump blood into your body. That can add stress on your blood vessels and heart.
According to these statistics, 6 out of 10 persons who have diabetes also have high blood pressure. Diabetes results in an increased risk of heart disease due to the chronically high levels of sugar in the blood causing damage to the blood vessels.
Smoking can increase your blood pressure and can damage your blood vessels and heart. Smokers are also more likely to develop more severe forms of hypertension.
- Excessive alcohol consumption
Excess drinking of alcohol can result in a sustained elevation of blood pressure, leading to essential hypertension. Alcohol is also linked to diabetes and obstructive sleep apnea, which can cause secondary hypertension.
- Physical inactivity
Regular physical activity helps your blood vessels and heart to stay healthy and strong. Lack of physical inactivity increases the risk of obesity, which in turn increases your risk for high blood pressure.
And some other risk factors include:
- Genetics: hypertension tends to run in the family. If your parents have hypertension, you are recommended to keep an eye on your blood pressure.
- Age: age increases your hypertension risk.
- Race: statistics show that Malays have higher incidents of high blood pressure than Chinese and Indians.
What is the Treatment for Hypertension?
As a chronic disease, hypertension treatment is usually lifelong and best to be combined with lifestyle modification to manage the risk factors. Doctors may prescribe you with pharmaceutical drugs to keep blood pressure in check, as well as to reduce the side effects that come with high blood pressure such as the risk for heart attack or stroke. You will also be advised to measure and take note of blood pressure regularly at home.
Lifestyle changes are crucial in managing high blood pressure. Here are some best modifications that will help in addressing the risk factors and lowering your high blood pressure:
- Quitting smoking.
- Limiting the use of alcohol to two drinks per day or less for men, and one per day for women.
- Eating a healthy diet that includes more vegetables and fruits and less saturated fat, low dairy fat, etc.
- Losing weight if you are obese.
- Taking regular aerobic exercise such as walking, cycling or swimming for a minimum of 30 minutes per day.
- Limiting the sodium amount to 1500 milligrams per day in your diet. In the case of healthy adults, this amount shouldn’t cross the limit of 2300 milligrams.
Measure Blood Pressure Correctly
It’s important to take accurate blood pressure readings so that your doctor can provide the optimal treatment to manage your hypertension and its risks. Blood pressure readings can be affected by a few factors, so bear the following in mind for measurements:
What are the Complications of Untreated Hypertension?
High blood pressure increases the risks of narrowing and hardening of arteries that is also known as atherosclerosis. You can face the following health problems if you are having improper or no treatment for hypertension.
- Coronary heart disease
- Kidney failure
- Peripheral artery disease (narrowing of blood vessels in the limbs)
These complications and their related risk will also increase if you
- Have a high level of cholesterol
- Are diabetic
- Are overweight
- Are a smoker
Managing Hypertension Anywhere With OneCare and Ninkatec
With care services provided at 23 OneCare clinics complemented by home care services by Ninkatec at home, we are with you every step of the way to help you manage hypertension effectively. We understand the challenge of managing a chronic disease for lifetime and offer solutions to provide quality care for patients with hypertension wherever you are, around the clock. Drop-in any of our OneCare clinics to enquire more or chat with us through Ninkatec website for a consultation of your specific hypertension care needs.