6 Misconceptions You May Have About High Blood Pressure

High blood pressure, or hypertension, is a chronic medical condition in which the force of the blood pushing against the blood vessels is elevated. In essence, the higher your blood pressure, the harder your heart has to pump.

As there are no obvious symptoms, many people may not know they have high blood pressure until it is too late. The 2010 National Health Survey in Singapore found that over 26% of people diagnosed with hypertension in the survey were not previously diagnosed – which means they didn’t even know they had high blood pressure.

Unfortunately, the onset of symptoms can often mean we are already suffering from a serious medical condition such as heart, brain, kidney and other diseases. This is why it is also commonly referred to as a “silent killer”.

The National Health Survey also found that more than half of Singapore residents aged 60 to 69 had hypertension. However, it isn’t a disease that only older folks should be concerned with as nearly 1 in 4 people aged 30 to 69 were found to have high blood pressure.

We spoke to Dr Michael MacDonald, a senior consultant cardiologist at The Harley Street Medical Group, to get a deeper understanding of common misconceptions people have about high blood pressure in Singapore.

Misconception #1: I do not feel unwell. I can’t have hypertension (or hypertension can’t be that bad).

Dr Michael says a classic misconception people had was thinking they would have a headache if they have high blood pressure. This is completely wrong – high blood pressure is 95% asymptomatic, which is exactly why it is also termed a silent killer.

If we start to get symptoms from high blood pressure, it actually suggests we may have started to get organ damage caused by the high blood pressure – which can be very late in being able to effectively manage the disease without medication.

Misconception #2: High Blood Pressureis an old-age disease. We don’t have to worry about it until we are about 60-years-old

There’s no doubt that as we get older, our blood pressure goes up.

But, Dr Michael notes that it’s surprisingly common in young people as well. Just to go to some statistics, he pored over the  National Health Survey in 2010 – which stated that about 8% of people between 30 to 39 had high blood pressure in Singapore. For those between 40 and 49, it goes up to about 17%.

So, even among young people, there’s quite a significant rate of hypertension. And this is only going to increase, because people are becoming more overweight. Obesity itself is another growing problem in Singapore, with the proportion of children in school, aged 6 to 18 years – seeing obesity levels increase from 11% in 2013 to 13% in 2017, according to the Ministry of Health.

With obesity, the risk of high blood pressure increases. So, it’s definitely not only an old-age disease.

Of course, high blood pressure is also related to other lifestyle-related causes, such as living a sedentary lifestyle, poor quality diet (eating higher quantities of processed foods, trans fats and salt), smoking and excess alcohol also pushes hypertension risk factor up.

Another big one in Singapore is also sleep apnea –  about a third of the population has sleep apnea which is associated with high blood pressure as well.

Misconception #3: If we do not exceed 130/80 mmHg, we are safe from hypertension

Basically, if we have a blood pressure above 140/90 mmHg, we are defined as having high blood pressure in Singapore.

Top number is called systolic – that’s the pressure in the main artery (aorta) or the blood vessels when the heart is contracting.

The bottom number is diastolic – that’s the pressure in the arteries when the heart is relaxing.

Dr Michael adds that we have these cut-offs in the medical community to define when patients need treatment. But realistically, blood pressure is a continuous variable that has to be managed. The higher our blood pressure, the higher the risk of heart attacks and related diseases.

While these are the cut-offs, it’s also a guideline in Singapore. Different countries do have different guidelines to Singapore. For example, in the U.S., they have a stricter guideline stating that anything above 130 mmHg is Stage 1, and people with 120-129 have elevated blood pressure.

Regardless of where we may live, the rule of thumb is that we want our blood pressure to be less than 120/80 mmHg.

Dr Michael also points out that even if we’re safe from high blood pressure, it doesn’t mean we’re in the clear for diseases like heart attack, which also has other risk factors.

Misconception #4: Hypertension cannot be prevented, so we can’t do anything about it

Some hypertension can’t be prevented. If you’ve got a kidney disorder or an endocrine disorder, you can’t prevent hypertension from happening.

However, a lot of hypertension can be prevented. We see many people who are obese having high blood pressure. When these people lose weight their blood pressure can lower, and even normalise if their BMI lowers into the healthy range. One way to prevent high blood pressure is to prevent obesity. The same goes for other lifestyle-related improvements we can make, including eating right, cutting out smoking and excess alcohol.

There are statistics to suggest that up to 80% of heart attacks and strokes may be preventable if we start addressing lifestyle.

Misconception #5: I don’t put a lot of salt in my food and/or I don’t like salty foods, so I should be safe from hypertension

It’s never just about salt or being overweight or smoking. These things are usually interconnected with a person leading a poorer quality lifestyle.

Another misconception is about the salts that we eat. For one thing, salt is likely part of the problem but many times it is probably one of the minor risk factors, especially compared to weight.

When it comes to salts, there also aren’t “healthier” salts – be it Himalayan salt or sea salt. They’re all sodium chloride so they’re all the same. There are some “low salt” salts that are potassium chloride rather than sodium chloride, but they can be dangerous in high quantities.

Misconception #6: Even if I get hypertension, I can go to the doctor to cure myself

If our blood pressure is not so bad – for example Grade 1 hypertension – it is potentially treatable with lifestyle modifications. If people are relatively low-risk, Dr Michael says doctors actually give them 3 to 6 months of lifestyle modifications.

He has seen a lot of patients who are able to use this time to lower their blood pressure once they’re made aware of it. They lose weight, start exercising, eating nutritious foods and cut out processed foods, and put themselves into hypertentive remission.

But if patients have blood pressure that is really high to begin with, then it is challenging to bring it down with just lifestyle modifications alone. These patients usually require blood pressure medication.

Dr Michael reminds us, though, blood pressure is a continuous variable. If the same patients who go into hypertentive remission do not keep up their lifestyle adjustments, they will start seeing their blood pressure go up again.

Simple lifestyle changes you can make to reduce your risk of hypertension

One of the simplest things Dr Michael says we can do is to get our blood pressure checked at least twice a year. In fact, he thinks everyone should get a home blood pressure monitor so we can check our own and our family’s blood pressure on a regular basis.

Second thing, and also one of the most important, is to keep our weight within a healthy range – this can be guided by the BMI range of less than 23 for Asians. This includes making sure we exercise, as it helps control our blood pressure, eat right, sleep enough, as well as avoid unhealthy habits like smoking and excess alcohol consumption.

Even when we get Grade 1 hypertension, it is possible to go back into healthy blood pressure range with lifestyle medications for many of us. However, if we lose our discipline, we will just see our blood pressure go up again – which effectively means that we need to think about lifelong changes to our lifestyle rather than short fixes.

Of course, it’s not just about lifestyle. Some do have a genetic tendency of high blood pressure, so it’s still worth checking your blood pressure regularly. While 95% of high blood pressure have no obvious cause and are lifestyle-related, there are also other causes of high blood pressure, whether it’s kidney disease or hormonal diseases.

Even if we do get hypertension, we can continue trying to live healthier while going on medication to control our hypertension from becoming worse.

For more tips to improve your overall well-being, check our AXA Health page. If you would like to protect yourself from future health risks, consider purchasing AXA health insurance for your protection.

Dr Michael is a consultant cardiologist at the Harley Street Heart and Vascular Centre. He sub-specialises in preventive cardiology and heart failure and is a certified obesity physician with interests in complex cardiovascular diseases in overweight patients.

Disclaimer:

This article is for general information only and does not take into account the specific investment objectives, financial situation or needs of any particular person. The views expressed herein do not necessarily reflect the views of AXA Insurance Pte Ltd and should not be construed as the provision of advice or making of any recommendation. There is no intention to distribute, or offer to sell, or solicit any offer to purchase any product. We recommend that you seek the advice of a qualified financial advisory professional before making any decision to purchase an insurance or investment product. Whilst we have taken reasonable care to ensure that all information provided was obtained from reliable sources and correct at time of publishing, information may become outdated and opinions may change. We are not liable for any loss that may result from the access or use of the information herein provided.

This advertisement has not been reviewed by the Monetary Authority of Singapore.