New BP rate means 1 in 3 has hyper­ten­sion

The New Paper - - NEWS - SALMA KHALIK, SE­NIOR HEALTH COR­RE­SPON­DENT

AHA rec­om­mends new cut-off rate as 130/80 in­stead of 140/90

Overnight, Sin­ga­pore will have one in three peo­ple suf­fer­ing from high blood pres­sure in­stead of one in four — if it adopts a new cut-off rate rec­om­mended by the Amer­i­can Heart As­so­ci­a­tion (AHA).

But the vast ma­jor­ity of these newly di­ag­nosed hy­per­ten­sives, clas­si­fied as “high blood pres­sure stage 1”, will need to make only life­style changes to re­duce their risk of get­ting heart at­tacks and stroke.

The stricter rate rec­om­mended by the AHA is 130/80 ver­sus the ex­ist­ing 140/90.

It is based on solid ev­i­dence, said Pro­fes­sor Tan Huay Cheem, di­rec­tor of the Na­tional Univer­sity Heart Cen­tre, “so there’s no rea­son to re­ject these rec­om­men­da­tions”.

But he added: “We should still treat pa­tients with stage 1 hyper­ten­sion with life­style changes and start drug treat­ment only if he has mul­ti­ple other risk fac­tors (for ex­am­ple, di­a­betes mel­li­tus)”.

Prof Tan also said the 130/80 cut-off is for at least two read­ings done at home. The cut-off at clin­ics stays at 140/90 as anx­i­ety tends to raise a per­son’s blood pres­sure, he said.

TREAT­MENT

Dr Chee Tek Siong, a car­di­ol­o­gist in pri­vate prac­tice and a board mem­ber of the Sin­ga­pore Heart Foun­da­tion, shares Prof Tan’s view and said treat­ment would be given to high-risk pa­tients.

These peo­ple have is­sues such as di­a­betes, high choles­terol, ob­struc­tive sleep ap­nea or kid­ney fail­ure.

The AHA es­ti­mates that only one in five of the stage 1 hy­per­ten­sives might need med­i­ca­tion to re­duce their blood pres­sure. The rest should be given ad­vice to make life­style changes and have their blood pres­sure checked af­ter three to six months, he added.

Life­style changes in­clude re­duc­ing salt in one’s diet and eat­ing more potas­sium-rich foods such as ba­nana, potato, av­o­cado and dark leafy veg­eta­bles, ex­er­cis­ing more, drink­ing less al­co­hol and not smok­ing.

Dr Paul Chiam, a car­di­ol­o­gist at Mount El­iz­a­beth Novena Hos­pi­tal, high­lighted the need for peo­ple to know the im­por­tance of strict blood pres­sure con­trol “as we know that bet­ter BP (blood pres­sure) con­trol does lead to fewer strokes, heart and kid­ney dis­ease”.

Dr Daniel Yeo, a car­di­ol­o­gist at Gle­nea­gles Hos­pi­tal, noted that Canada and Aus­tralia adopted the stricter cut-off last year, so the AHA’s move was no sur­prise.

salma@sph.com.sg

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