High Blood Pressure


High blood pressure or hypertension is known as the silent killer responsible for strokes, heart attacks and kidney failures. It’s a medical condition in which the pressure in the arteries is elevated. This makes the heart work harder to circulate blood through the blood vessels. Blood pressure is measured by systolic and diastolic measurements. Systolic is when the heart is contracting (systole) and diastole is when the heart is at rest between beats (diastole) – the maximum and minimum pressure. Normal blood pressure at rest is within 100-140mmHg systolic and 60-90mmHg diastolic. High blood pressure is when it is consistently above 149/90 mmHg.

Hypertension is a major risk factor for stroke, heart attacks and other heart conditions and is a cause for chronic kidney disease. Even a “borderline” hypertension is associated with a shortened life expectancy.

Around 1 in 5 Singaporeans aged 18 and 69 years have high blood pressure. Dietary and lifestyle changes can control blood pressure and decrease the risk of associated health complications, although drug treatment is often necessary in people for whom lifestyle changes are not enough or not effective.

The different categories for blood pressure are listed below.

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


*Isolated systolic hypertension is graded according to the same level of systolic BP
Source: MOH Clinical Practice Guidelines 2/2005


One reason why high blood pressure is also referred to as the silent killer is symptoms do not appear until the blood pressure has significantly increased.

    Take note if you suffer from one or more of the following on a daily basis. You could have be suffering from hypertension.

  • Headache
  • Dizziness
  • Fatigue
  • Tinnitus (ringing in the ear)
  • Stiff neck



Some activities can cause blood pressure to temporarily increase, such as stress, change of weather, alcohol consumption, smoking, even bathing and physical activities. But for most sufferers of hypertension, the cause is likely in their lifestyle, habits or other medical conditions.

    Blood pressure fluctuates depending on the time of day, physical activity and emotions. Therefore, it has to be taken under resting conditions and more than once. 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.

Managing high blood pressure

    You should check your blood pressure at least once a year. Marginally lhigh blood pressure may normalise when you lose weight, exercise more and reduce salt intake.

  • Eat a healthy diet – Avoid foods high in cholesterol and saturated fats such as animal fats, whole milk products, eggs, red meat such as beef and lamb, coconut milk and palm oil. Instead, choose lean meat, fish and low-fat dairy products and increase your intake of fruits and vegetables. Cut back on salty foods as well.
  • Exercise regularly – It is important to exercise at least three times a week. Although there are many kinds of physical activities you could do, walking is one of the best forms of exercise to do. To find out which types of physical activities are suitable for you, check with your doctor.
  • Watch your weight – It has been proven that maintaining a healthy body weight reduces the risks of high blood pressure. To give you a good idea of whether you are keeping a healthy weight, refer to above table.
  • Quit smoking – Smoking can elevate the blood pressure and is also an independent risk factor for coronary artery disease and stroke.
  • Take it easy – To manage stress, engage in regular exercises. Adopt a balanced approach to work and family life. In addition, relax whenever possible to ease the tension whenever feelings of stress arise since stress may aggravate your blood pressure.

If these measures are not successful, then drug treatment maybe needed. However, once medicine has been started, it is essential to continue with the treatment, complemented by a healthy lifestyle. Treatment of hypertension for most people is life-long.