What is hypertension? How do I know if I have hypertension?

Hypertension, also known as high blood pressure, is when your blood pressure is consistently elevated.

What is "White Coat Hypertension" ? Is it a real phenomenon?

White coat hypertension occurs when your blood pressure readings at the doctor's office or hospitals are higher than they are in other settings, such as your home.

People used to think that white coat hypertension was caused by the stress brought about by doctor's appointments. However, current research indicates that white coat hypertension may be an indication of real hypertension. In fact, a study found that people with untreated white coat hypertension had a 36% higher risk of heart attack, stroke and other cardiovascular conditions; they were also twice as likely to die from heart disease.

What are some factors that may put you at risk for hypertension?

A. Age

The prevalence of hypertension increases with age.

B. Family History

High blood pressure tends to run in families, because people in the same family tend to have the same genes that can predispose them to high blood pressure. Having one or more close family members with high blood pressure before the age of 60 means that you have two times the risk of having it.

C. Lifestyle

A diet with excessive amounts of sodium and inadequate amounts of potassium puts you at risk of high blood pressure.

Obesity means that your heart has to work harder to pump blood around your body, adding stress to your heart and blood vessels, thus raising blood pressure. Physical inactivity is also a contributing factor to obesity as low levels of physical activity will result in weight gain.

Drinking too much alcohol and smoking also increases your risk for high blood pressure.

D. Medical conditions

Existing medical conditions may also result in secondary hypertension - high blood pressure caused by another condition or disease.

Obstructive Sleep Apnea (OSA)

OSA is a sleep disorder that causes numerous lapses in breathing during sleep. In healthy individuals, blood pressure naturally lowers at night. However, people with severe OSA experience blood pressure dips to a smaller extent. This results in an overactivation of the nervous system, secreting adrenaline. An excessive activation of the system can lead to chronically elevated blood pressure.

Diabetes

Diabetes causes the walls of the blood vessels to stiffen, causing blood pressure to rise, eventually leading to hypertension. About 60% of people who have diabetes also have high blood pressure.

Thyroid disorders

This results in the production of elevated levels of hormones. The change in hormone level may lead to hypertension.

How does the doctor confirm that you have hypertension?

A hypertension diagnosis is rarely given after only one blood pressure reading. During a screening, if the blood pressure is elevated, a few more readings would be taken over the next few days or weeks. If the blood pressure remains elevated for the next few readings, the doctor may then conduct tests to rule out underlying conditions. These tests help the doctor to identify any secondary issues causing the elevated blood pressure level. They can also check if the high blood pressure has affected the organs.

Is screening important in the detection of hypertension?

Screening is especially important for hypertension because there are no warning signs for high blood pressure. Many people do not even realise that they have high blood pressure until their vital organs have been affected. Furthermore, high blood pressure is extremely prevalent amongst Singaporeans, with 25% of people aged 30 to 69 having high blood pressure.

Hypertension leads to many severe complications, and it is important to undergo health screenings regularly in order to discover the illness early. Early treatment typically results in more effective blood pressure control, and will also limit damage to our arteries. This significantly reduces the incidence of cardiovascular events.

What are some complications that may be caused by hypertension?

High blood pressure can lead to many other health complications, such as stroke, heart attack and kidney failure. After an extended period of high blood pressure, our arteries will harden, and therefore less blood will be delivered to our organs.

A. Heart attack

This occurs when the heart is deprived of oxygen and consequently does not function. Due to hypertension, arteries around the heart may be blocked, resulting in angina. In serious cases, blood may not be able to flow at all, leading to a heart attack.

B. Poorer Cognitive Function/ Stroke

High blood pressure may also lead to aneurysms or microbleeds in the brain, which may lead to poorer cognitive function and stroke. When the arteries near the brain rupture or are blocked, a stroke may occur, causing brain cells to die. A stroke can cause serious disabilities in speech, movement and more.

C. Chronic Kidney Disease

Adults with hypertension are also at a higher risk of developing chronic kidney disease. High blood pressure causes arteries around the kidneys to narrow or harden. The kidneys are unable to remove wastes and extra fluid from the body, and the extra fluid in the blood vessels can further raise the blood pressure.

How do you know if you have hypertension?

Hypertension is a silent condition, with little to no warning signs and symptoms. Measuring your blood pressure is the only way to detect if you have hypertension. However, if your blood pressure has been high for a long period of time, some symptoms include:

• flushing
• blood spots in the eyes (may be due to subconjunctival hemorrhage)
• dizziness

For more information or if you require a medical consultation, please contact My Healthcare Collective here.