Hypertension Treatment

What is hypertension?

Hypertension or high blood pressure is a condition where your blood pressure, which is the force of the blood flowing through your blood vessels, is consistently too high. Cardiologists are medical specialists who treat patients with hypertension and related heart conditions.

What are the symptoms of hypertension?

Most of the time, there are no obvious symptoms of hypertension. If left untreated, the pressure damages the circulatory system and is a significant risk factor for heart attacks, strokes, and other health threats.

What are the causes of and risk factors for hypertension?

There are two types of hypertension:

● Primary hypertension
For most adults with primary hypertension, there is no identifiable cause of high blood pressure as this form of hypertension tends to develop over a long period of time.
● Secondary hypertension

Some people with secondary hypertension have high blood pressure caused by another condition such as:
● Obstructive sleep apnoea
● Kidney problems
● Adrenal gland tumours
● Thyroid problems

A number of factors can put a person at a greater risk for developing high blood pressure. These include:

● Family history
● Age
● Gender
● Sedentary lifestyle
● An unhealthy diet
● Being overweight or obese
● Excessive alcohol consumption

Did you know?

The Well-being of the Singapore Elderly (WiSE) study showed that 75% of the more than 2,400 randomly selected elderly aged 60 and older had hypertension. Those with hypertension were also more likely to report a diagnosis of diabetes¹.

What are the possible complications of hypertension?

High blood pressure damages the walls of the fragile blood vessels. This causes plaque comprising of Low Density Lipoproteins (LDL), a type of unhealthy cholesterol, to be accumulated on the inner walls of the vessels, the start of atherosclerosis. Over time, as more plaque is deposited, the vessel lumen becomes narrower and blood pressure increases, giving rise to more damaged arteries, affecting the heart and the rest of your body.

Some complications of hypertension include:

● Aneurysms, as the pressure could weaken the wall of the vessel causing a bulge. If a rupture occurs, this could be a life-threatening event.
● Heart attack or stroke, as atherosclerosis leads to a narrowing of the arteries and the risk of a clot increases if the plaque breaks off.
● Heart failure, as the heart muscle thickens due to the increased pressure. Eventually, the thickened muscle may not be able to pump blood effectively around the body.
● Impaired renal function, as the blood vessels within the kidneys are weakened and narrowed
● and vision loss, due to torn blood vessels in the eyes.

When should I see a specialist for hypertension?

You may wish to see a cardiologist if your blood pressure reading has been elevated persistently. One high reading does not mean a high blood pressure diagnosis. It is necessary to measure your blood pressure at different times, while you are resting comfortably, for at least five minutes.

How should I prepare for my appointment?

You may wish to wear a short-sleeved or loose top as your blood pressure is likely to be taken at the clinic.

As your cardiologist will ask you for your past medical and family history, be prepared with the following information:
● Current symptoms that you are experiencing including those that seem unrelated
● Current or previous medical conditions including any treatments such as diabetes or stroke
● Results of previous laboratory tests, such as cholesterol tests
● List of medications, vitamins, or supplements you are currently taking.
● Be prepared to discuss your diet and your smoking and exercise habits. If you do not already follow a diet or exercise routine, discuss getting started with one.

How do specialists diagnose hypertension?

Cardiologists measure blood pressure using a sphygmomanometer.

If you are diagnosed with high blood pressure, your cardiologist may recommend other tests to check for any heart damage:

● An echocardiography is an ultrasound of the heart to create dynamic pictures of your heart that shows the shape and size of your heart, as well as how well your heart’s chambers and valves are working.
● An electrocardiogram, also known as ECG or EKG, examines the electrical impulses of your heartbeat, showing the speed and rate of the beats. This will help them determine any abnormality and identify the cause. Electrodes are placed on the skin of the chest, arms, and legs and connected to machines that record the electrical activity.

What treatments are available for hypertension?

The goal of hypertension treatment is to lower high blood pressure and protect the brain, heart, and kidneys from damage.

To do this, typically, your cardiologist may advise changes to your lifestyle habits such as:

● reducing your salt intake,
● losing weight if you are overweight or obese,
● or exercising regularly if you are not

Your cardiologist may also prescribe a drug regimen that may consist of one or a combination of the following, depending on your condition:

● Angiotensin-converting enzyme inhibitors to help relax blood vessels,
● Diuretics to help your body remove sodium and water, reducing blood volume,
● or beta blockers to open your blood vessels, causing your heart to beat slower and with less force.

After starting high blood pressure drug therapy, you are likely to see your cardiologist regularly until the blood pressure goal is reached.

Our cardiologists at Mount Elizabeth Medical Centre will work with you to control or improve your condition to enable you to live an active, healthy life.

[1] Seow LSE, Subramaniam M, Abdin E, Vaingankar JA, Chong SA. Hypertension and its associated risks among Singapore elderly residential population. J Clin Gerontol Geriatr. 2015;6(4):125-132. doi:10.1016/j.jcgg.2015.05.002.