No change to blood pressure limits in S’pore: MOH

[손명숙]

(Singapore Today Friday 17 November 2017)

No change to blood pressure limits in S’pore: MOH

The Ministry of Health said that it is keeping to its definition of hypertension as

when blood pressure is more than 140/90mmHg. Photo: Emmy Smith/Unsplash

Updated 17 November, 2017

SINGAPORE — The Ministry of Health (MOH) said that it is keeping to its definition of hypertension as when blood pressure is more than 140/90mmHg, even though the American Heart Association (AHA) has lowered that limit to 130/80mmHg.

Responding to media queries, the ministry said on Thursday (Nov 16) that the new measurement was developed in the context of the population in the United States, and it would continue to review supporting evidence of the new AHA guidelines and whether they apply to the Singapore population.

MOH noted that in the US, the revised standards “do not change the approach to management (of hypertension) in a major way”.

On Monday, the AHA, American College of Cardiology and other health experts tightened the guidelines for high blood pressure, the first change in the US in 14 years. With the change, it means that close to half of the adults there will be considered as having hypertension. The number of men younger than 45 with a diagnosis of high blood pressure will triple, and among women younger than 45, it will double, news reports said.

The AHA’s stance is that the disease should be treated sooner, when it reaches a reading of 130 over 80.

Elaborating on why it is not changing the limit, the MOH said that the 140/90mmHg reading still reflects the general consensus globally supported by guidelines from societies such as the International Society of Hypertension, the European Society of Cardiology and the National Heart Foundation of Australia.

It added that these guidelines also adopt “a risk segmented approach” in deciding when treatment starts, and target blood pressures depending on the patient’s cardiovascular risk factors, apart from blood pressure.

While the number of people in the US being diagnosed as having hypertension would go up, the MOH noted that only about 36 per cent would be recommended medication.

The new US guidelines incorporate and define patients with stage 1 hypertension as a patient having systolic blood pressure between 130 and 139, and diastolic blood pressure between 80 and 89. The systolic reading refers to the pressure when the heart contracts and sends blood through the arteries. The diastolic reading refers to the pressure when the heart relaxes between beats.

Commenting on the updated categories, the MOH said: “Low-risk stage 1 hypertensive patients are not recommended medication, although treatment is recommended for stage 1 hypertensive patients with a previous cardiovascular event, or patients at high risk for an event, such as patients with diabetes or chronic kidney disease.

“Essentially, while these new guidelines change the definition of hypertension for US patients, they do not change the approach to management in a major way.”

To keep blood pressure in the healthy range, the MOH advised individuals to live a healthy lifestyle such as having a balanced diet, avoiding excess salt intake, having regular physical activity, and not smoking.

“Individuals are encouraged to adopt and maintain healthy living to reduce their risk of hypertension and its associated cardiovascular complications such as heart attack, stroke and renal failure.”