What is Hypertension?
Hypertension, commonly known as high blood pressure, means high pressure (tension) in the blood vessels.
Our blood pressure rises and falls with each heartbeat. These levels can change with everyday activity, for
example, during exercise or sleep and this is normal. However, in some people, especially older people, these
changes in blood pressure start to happen at higher pressure levels and this is what high blood pressure means.
What blood pressure is considered high?
Blood pressure is high when it persistently exceeds 140/90 mmHg on several occasions. However, defining normal
and abnormal is not always so clear-cut and it is advised that you confirm with your doctor.
How do you get High Blood Pressure?
No specific cause is found in 95% of patients with hypertension – this is called primary hypertension.
•In primary hypertension, there is increased stiffness and narrowing of the smaller (peripheral) arteries.
•This results in increased resistance to the flow of blood and is what makes the blood pressure go up.
•Increased peripheral artery resistance is associated with genetics (family history), obesity, lack of exercise, over
use of salt, and the natural ageing process.
•A few patients have high blood pressure with a known cause (secondary hypertension). Long-lasting (chronic)
kidney disease accounts for most of these patients where there is excessive fluid accumulation in the body that
raises blood pressure. Hypertension can also occur during some pregnancies.
How serious is High Blood Pressure?
Over time, it can cause damage to the tiny blood vessels and this may affect the function of the heart, eyes, and
kidney. Again, over time it can affect the larger arteries as well and contribute to hardening of the arteries. This
explains why people with untreated high blood pressure have a higher risk of suffering from a stroke, heart attack
and heart failure.
For this reason it is important that treatment with a blood pressure lowering medicine is given for a long period of
time, which in most cases is for life.
And, because blood pressure tends to go up, as we get older, we should have our blood pressure checked
regularly, even if our blood pressure is ‘normal’.
How long does High Blood Pressure last?
High blood pressure may be present for several years before it is detected and is often found during a routine
check-up. Usually there are no symptoms and consequences may only become apparent after many years.
How is High Blood Pressure treated?
There are known benefits from treating high blood pressure at any age, even in older patients of 65 years and
over. Depending on the level of the blood pressure, different things are recommended.
For mild elevations in blood pressure, a change in diet, weight reduction and adopting a healthy lifestyle may
reduce the blood pressure to normal.
If necessary, high blood pressure can be treated with a range of different medicines, including:
•Beta-blockers
•Diuretics
•Calcium-channel blockers
•ACE inhibitors
Maintain constant communication with your doctor. Do not stop your medications even if you feel normal. Always
check with your doctor first.
The SingHealth Team