High Blood Pressure (Hypertension) Management - What is it for

What is high blood pressure?

Blood pressure is the force created by the heart pump to move blood around the body. Blood carries nutrients and oxygen to all parts of the body. High blood pressure, or hypertension, refers to a condition in which the blood is pumped around the body at a higher pressure.

It is one of the major risk factors for coronary artery disease and stroke. Untreated hypertension can also cause heart failure and renal failure. Hypertension is the most important risk factor for development of intracerebral bleed.

In general, blood pressure fluctuates with the time of day, physical activity and emotions. Therefore, blood pressure has to be taken under resting conditions and on more than one occasion. Normally, your blood pressure will increase if:

Your blood volume is increased by too much salt intake which retains more water in the body.
Your blood vessels become more rigid due to atherosclerosis, a process where fatty substances are deposited in the blood vessel walls.

What are the categories of blood pressure levels?

The different categories of blood pressure levels are listed below.

Categories of Blood Pressure (BP) Levels in Adults Age 18 Years and Above

	Blood Pressure Level (mmHg)
Category	Systolic BP (mmHg)	Diastolic BP (mmHg)
Normal BP	< 130	< 80
High - Normal BP	130 – 139	80 – 89
Grade 1 Hypertension	140 – 159 *	90 – 99
Grade 2 Hypertension	160 *	100
Isolated Systolic Hypertension*	140	< 90

*Isolated systolic hypertension is graded according to the same level of systolic BP

Source: MOH Clinical Practice Guidelines 2/2005

How prevalent is hypertension?

According to the Singapore National Health Survey (1998), 27.3% of Singaporeans between the ages of 30 and 69 years, suffer from hypertension.

High Blood Pressure (Hypertension) Management - Symptoms

High Blood Pressure (Hypertension) Management - How to prevent?

High Blood Pressure (Hypertension) Management - Causes and Risk Factors

What are the risk factors for high blood pressure (hypertension)?

Your blood pressure can be elevated by alcohol consumption, smoking and obesity. You can reduce your risk of getting high blood pressure by keeping your body mass index (BMI) between 18.5 and 22.9 (see below table).

Body Mass Index (BMI) Classification by Public Health Action in Asians

Body mass index = Weight (kg)/ (Height x Height (m))

BMI (kg/m2) (for adults)	Risk of Heart Disease and Diabetes
27.5 and above	High Risk
23.0 - 27.4	Moderate Risk
18.5 - 22.9	Low Risk (healthy range)
Less than 18.5	Risk of nutritional deficiency diseases and osteoporosis

Source: Health Promotion Board

Hypertension usually causes no symptoms, but often leads to the damage of various body organs in the long-term. It is for this reason that high blood pressure or hypertension is referred to as “the silent killer”. Over time, it can lead to damage of the heart and blood vessels, leading to stroke, heart attack or renal failure. Occasionally, when the blood pressure is extremely high, headaches, dizziness or alterations in vision can be experienced.

Older people are at a higher risk of developing hypertension. Most of the patients are found to have no cause for the high blood pressure and are categorised as essential hypertension. About 10% of high blood pressure patients have it as a result of kidney diseases or hormonal disorders (secondary hypertension).