Around a quarter of people aged 30 to 69 in Singapore have high blood pressure, and may be at risk of serious complications. The number rises as we age – around 1 in 2 people aged 60 to 69 in Singapore have high blood pressure Having regular check ups, especially as we get older or if we are at risk of cardiovascular disease, is the best way to find out if you have high blood pressure.
What Should My Blood Pressure Be and Why Does it Matter?
Checking your blood pressure is one of the most frequent and basic elements of any health check or visit to a GP or nurse. Routine observations in hospital settings place high importance on blood pressure, and a blood pressure reading can be a good indication of a person’s current health and their risk of developing serious health conditions. You can also measure your blood pressure yourself at home using a blood pressure machine.
When your blood pressure is taken, it is reported as two numbers – the systolic and diastolic blood pressure. The unit of measurement is mmHg – millimetres of mercury, an old way of measuring pressure.
Systolic Blood Pressure
With each heartbeat, blood is pushed into the circulation – the first number in a blood pressure reading represents the strongest rush of blood into the body. It is the pressure of the blood within the vessels at the strongest contraction of the heart with every heartbeat. The strongest part of the heart’s contraction is called systole, and the blood pressure at that point is known as systolic blood pressure.
Diastolic Blood Pressure
The second number is the pressure in the blood vessels when the heart is at its most relaxed state – at the point of each heartbeat when the heart isn’t forcing blood into the vessels.
The ideal blood pressure is a little different for everyone and blood pressure changes from one moment to the next. A target for healthy blood pressure should be consistently less than 130/80, although some people may have slightly different targets depending on other health conditions.
Blood Pressure Chart
Here’s the blood pressure classification according to Singapore’s guidelines:
- Normal: A blood pressure reading lower than 130/80 mm Hg is considered to be within the normal range. At this stage, no treatment is necessary, but it is recommended for us to continue monitoring our blood pressure to ensure it stays within the healthy range.
- Pre-hypertensive: Individuals with a blood pressure reading between 130/80 to 139/89 mm Hg are considered pre-hypertensive and are at risk of moving on to develop heart disease. While medication may not be required at this point, lifestyle measures to reduce blood pressure are recommended.
- Hypertensive: If you have a blood pressure reading of 140/90 mm Hg and above, your doctor may prescribe medication and recommend lifestyle changes to lower your blood pressure and reduce your risk of stroke and heart diseases.
There are lots of different underlying factors which can cause high blood pressure, and sometimes people have high blood pressure without any clear reason.
Having narrowed or hardened blood vessels raises the pressure within the entire circulatory system, causing high blood pressure readings. This may be caused by fatty plaques that build up within the vessels, and puts people at a higher risk of hypertension.
Having high blood pressure due to fatty plaques makes us much more likely to develop cardiovascular conditions like heart attacks and strokes. This is because the force of high blood pressure against an unstable deposit of fat in the vessel can cause the fatty build-up to shear off into the circulation, causing clots and blockages within our arteries.
Underlying health conditions can cause high blood pressure. These include kidney disease and diabetes. There are also some drugs which can raise blood pressure, including common medications like the contraceptive pill or NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen. If you have any concerns about medications and side-effects, consult a GP.
Symptoms of High Blood Pressure
People can have high blood pressure for a long time without experiencing any symptoms at all. They may only discover their hypertension at a routine health check or when they become unwell. When symptoms do occur alongside high blood pressure, they can be quite vague and be mistaken as symptoms for other conditions instead.
Symptoms of high blood pressure can include headaches, chest pain, nosebleeds and dizziness.
What Can I Do to Lower my Blood Pressure?
Lowering blood pressure takes a combination of factors, and so requires a multi-pronged approach.
Reaching or maintaining a healthy weight through a combination of a good diet and exercise is the single most important thing we can do to help improve our blood pressure. Changing our lifestyles to include healthy fresh air and exercise and a diet rich in essential nutrients and low in the foods known to cause high blood pressure is something we should all do.
Smoking has a seriously negative effect on blood pressure, so stopping smoking is essential when you are trying to improve your blood pressure. Furthermore, quitting smoking also improves your overall general health and can vastly reduce your risk of serious and potentially deadly conditions like lung cancer and ischaemic heart disease.
Chronic (long-term) stress is also strongly associated with high blood pressure although the link is not completely clear. Fluctuations in blood pressure may be partly due to the hormonal peaks and troughs that go alongside stress and anxiety, or it may be caused by some of the activities that we turn to as a way of soothing ourselves when we are stressed. For instance, overeating, smoking, alcohol, and inactivity are contributors to high blood pressure.
Good Foods to Fight High Blood Pressure
The nutrient profiles of foods are important – we need to make sure we get the right amount of fibre, protein, carbohydrates and fat in our diet, as well as the micronutrients – those vitamins and minerals that help to keep us healthy. Most of us already know what the components of a sensible healthy diet would be – lean proteins, lots of fruit and vegetables, and wholegrain carbohydrates. It is also important to eat a wide range of different foods as this helps us get the full range of nutrients into our bodies.
Here are some types of food that can help us lower and maintain our blood pressure at a healthy level.
Fibre is the part of food that travels through the body relatively unchanged. There are two types of fibre – soluble and insoluble fibre. Soluble fibre is dissolved in the body and passes into the bloodstream, where it acts to reduce cholesterol and regulate blood sugar levels. Insoluble fibre passes through the gut and helps our body move food through the digestive system, keeping bowels healthy and ensuring essential nutrients are absorbed into our system.
A high fibre diet can help us maintain a healthy weight, control our blood pressure, and lower our risk of bowel cancer and other diseases.
High fibre foods include most vegetables, fruit, and wholegrains like brown rice and wholewheat bread.
Not all fats are equal when it comes to our health. Including healthy fats such as seed and nut oils in your diet is vital as they can be high in essential vitamins and nutrients. Oily fish is a particularly good source of Omega 3 – an essential fatty acid which helps maintain good cardiovascular health and reduces blood pressure.
Choosing healthy fats is important, but it is still a good idea to make sure that there is not too much fat in your diet. It is recommended that less than 30% of our overall calorie intake should come from fats. While we may instinctively think of cooking oil when discussing fats, we can actually get most of our good fat intake without adding extra cooking oil just by eating oily fish, seeds, nuts, and fatty vegetables like avocados and olives.
Choosing protein carefully helps keep dietary fat intake in check. Meat is an excellent source of protein and other nutrients, but choosing lean meats like poultry is much better for your blood pressure than red, fatty, or processed meat.
Choosing plant-based proteins like nuts, seeds, beans, legumes, and soy-based products like tofu is a good way to get healthy fats, fibre and micronutrients alongside your protein. Getting your nutrients from a range of healthy sources is important.
Fruit and Vegetables
The benefits of having lots of fruit and vegetables in your diet really cannot be stressed enough: we should all eat more fruit and vegetables. The micronutrients in fruits and vegetables vary from one type of plant to another, so including a bright range of fresh plant produce in your diet is important to obtain the different vitamins and minerals we need for a healthy life. Vegetables and fruit also contain good amounts of dietary fibre while being low in fat.
Some of the nutrients and beneficial compounds we need from food are highly coloured. Vitamin A is converted from beta-carotene – the compound that makes carrots orange and the anthocyanin that gives blueberries their colour has strong antioxidant cancer-fighting properties.
Hence, a simple rule of thumb will be to eat a wide range of colourful fruit and vegetables – a rainbow of food – to help fill us with important nutrients and give us the best possible health benefits. Fresh, dried, tinned and frozen fruit and vegetables can all count towards a healthy diet, although different preparations of fruit or vegetables can have slightly different nutrient profiles.
Foods to Avoid for People with High Blood Pressure
Knowing which foods can contribute to hypertension is as important as knowing which foods can help, and the more we understand how our diet affects our health, the more we can do to control it. Foods that can cause or worsen high blood pressure include:
The maximum amount of salt an adult should have in a day is 2000mg – that’s less than a teaspoon. Salt is added to most processed foods, so we often take in much more salt than we realise. There is a surprising amount hidden in some unexpected places, like bread or even breakfast cereals.
People who have more salt in their diet have higher blood pressure than people who do not take much salt. Even cutting back a little can help reduce the risk of high blood pressure.
However, high salt consumption usually tends to be chronic; people who eat a lot of salt with their food usually do so every day. This is because when we first cut back on salt, we will definitely notice the lack of taste in our food. However, high salt intake has both short- and long-term effects on blood pressure, and cutting back can quickly have positive results.
If you find it difficult to stick to a diet plan with a reduced salt consumption, try adding more herbs and spices to keep your food flavourful but healthy.
Some types of fat contribute to narrowed and hardened arteries, high blood pressure, and an increased risk of cardiovascular disease. Saturated fats are the main culprits for this. In general, you can identify them as fats and oils which are solid at room temperature. Fatty animal products such as red meat, butter, ghee and lard are all high in unhealthy saturated fat. However, do take note that plant oils are not automatically healthy, and coconut oil is also particularly high in saturated fats.
Replacing saturated fat with more healthy plant oils is a good idea, but most people still need to limit the amount of fat in their diet, regardless of its type. Low fat dairy products or dairy alternatives can be included in a healthy diet, although you should also watch out for hidden sugars in low fat foods.
Excessive alcohol intake can cause various health problems, including hypertension. There is some evidence that having a little alcohol – such as a small glass of wine two or three times a week – can have some health benefits, but the difference between a healthy amount and an unhealthy amount of alcohol can be difficult to judge.
The recommended maximum daily alcohol intake is up to one standard drink a day for women, and up to two standard drinks a day for men, with several alcohol-free days each week. A standard drink or unit of alcohol could be a can of regular strength beer or a small glass of wine. One 30 ml shot of a strong liquor like vodka or whiskey also counts as a single standard drink. Keep in mind that alcoholic drinks are also high in calories, and even more so when served with sugary mixers.
Red meat has a strong relationship with high blood pressure, even when other factors are taken into account. Choosing lean meats, fish, tofu, nuts, and other alternative protein sources is a good idea if you are trying to reduce your blood pressure.
Having a strong caffeinated drink can cause a short-term increase in blood pressure, especially if you do not take caffeine often and are not used to it. Caffeine can also make your heart race – even if you are used to it – which in turn can cause fluctuations in blood pressure. Some people are more sensitive to the effects of caffeine than others – some can drink cups after cup of strong coffee without a problem, whereas others quickly develop palpitations and headaches after just a little.
Eating a lot of liquorice can cause severe hypertension and heart rhythm disturbances. The risk becomes higher as we get older, and is particularly problematic for people with existing heart disease or high blood pressure, or who are at high risk of those conditions. For most people, having the occasional liquorice in healthy amounts does not cause any problems, but the risks of excessive liquorice consumption should be kept in mind.
A Good Diet for Hypertension
The DASH Diet
‘Dietary Approaches to Stop Hypertension’, commonly known as the DASH diet, was developed specifically to help people manage high blood pressure through a healthy diet and lifestyle. The DASH diet encourages a diet focused on wholegrains, fruit and vegetables, low-fat dairy and lean protein, and low in sodium and high in other minerals and vitamins. The DASH diet takes several dietary factors known to help control weight, blood pressure, and cardiovascular risk to create a simple set of guidelines for healthy living.
‘Mediterranean’ Style Diet
The ‘Mediterranean’ style diet is classically cited as being one of the most healthy diets around – a diet that focuses on lots of fresh vegetables and whole grains carbohydrates, and where dietary fats come mainly from good, fresh sources like olive oil and sardines.
My Healthy Plate
The Ministry of Health in Singapore has set out guidelines for healthy eating – ’My Healthy Plate’ which encourages people to think about the proportions of different types of food on their plates. The general rule is to fill half your plate with fruit and vegetables, a quarter with wholegrains, and a quarter with lean meats or meat alternatives, low fat dairy products, seeds and nuts.
Changing your diet can be difficult, even when your motivation is strong, and it is okay to sometimes slip up or indulge in something you know is not good for you. If you are aiming for perfection, it can feel like just trying your best is not good enough. That can be disheartening, but remember that any small healthy changes you can make are worth doing, and it is all a journey to be the healthiest you can be. Even baby steps count!
When to Get Help
Since the early stages of hypertension tend to not show any signs or symptoms, the only way to really know your blood pressure is by having it checked. It is a good idea to have this done regularly, especially as we get older or if we have other health conditions.
Measuring your blood pressure is a quick and simple procedure that can be done in the comfort of your home. You can have your blood pressure checked by your GP or a nurse. Buying a reliable home blood pressure monitor from a reputable pharmacy or other vendor means you can keep an eye on your blood pressure yourself at home, but do keep in mind that it is not a replacement for a regular health check. Home blood pressure monitoring only works if you know what to look out for and when to see a doctor about it, so if you do use a machine at home make sure you have access to support from a healthcare professional.
Diet and lifestyle changes can go a long way to improving blood pressure and general health. However, people with high blood pressure that’s hard to control should seek support from a healthcare professional. Your doctor may prescribe you a suitable dosage of medication to keep your blood pressure within a healthy range. For greater convenience, there is also the option to conduct follow-up consultations through a video call and have repeat medication for chronic conditions delivered to your doorstep. Learn more about how home care services can make help you manage hypertension better and more conveniently.
However, remember that medication works best alongside a healthy diet and exercise, and the health benefits of a healthy lifestyle go far beyond the prevention and management of any single condition.
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