{"id":273,"date":"2021-07-05T11:11:35","date_gmt":"2021-07-05T11:11:35","guid":{"rendered":"https:\/\/verztest.com\/frontier_healthcare\/?p=273"},"modified":"2023-08-07T10:45:18","modified_gmt":"2023-08-07T02:45:18","slug":"hypertension","status":"publish","type":"post","link":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/hypertension\/","title":{"rendered":"Hypertension"},"content":{"rendered":"<p><strong>Heart attacks\/diseases<\/strong> and <strong>strokes<\/strong> are commonly and collectively referred to as <strong>cardiovascular disease<\/strong>.<\/p>\n<p>Cardiovascular disease is a <strong>significant<\/strong> healthcare burden in Singapore. It contributed about 29.5% of the almost 19,000 <strong>deaths<\/strong> in 2013. This means that, <strong>1 in 3<\/strong> of us are likely to die from a <strong>heart attack, heart disease or stroke<\/strong>. If we exclude children and infants, this percentage will be even higher.<\/p>\n<p>The <strong>main risk<\/strong> factors for cardiovascular disease are:<\/p>\n<ul>\n<li>Hypertension<\/li>\n<li>Diabetes Mellitus<\/li>\n<li>High Cholesterol (Dyslipidaemia)<\/li>\n<li>Obesity and Smoking<\/li>\n<\/ul>\n<p>In addition, <strong>hypertension<\/strong> and <strong>diabetes<\/strong> are the <strong>top<\/strong> causes of <strong>kidney failure<\/strong> in Singapore and around the world.<\/p>\n<p>One in 4 Singaporeans aged 18-69 years has hypertension. The prevalence of hypertension and dyslipidaemia above 18 year olds in Singapore remain high at 23.5% and 17.4% respectively. <strong>Diabetes<\/strong> mellitus, <strong>obesity<\/strong> and <strong>smoking<\/strong> are also <strong>slowly increasing<\/strong> over the past 1-2 decades. (See table below)<\/p>\n<table style=\"width: 96%;\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\">\n<tbody>\n<tr>\n<td width=\"38%\" valign=\"top\">\n<p align=\"center\">\n<\/td>\n<td width=\"22%\" valign=\"top\">\n<p align=\"center\"><strong>1998<\/strong><\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\"><strong>2004<\/strong><\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\"><strong>2010<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\" width=\"100%\" valign=\"top\"><strong>Prevalence among adults aged 18 to 69 years(%)<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"38%\" valign=\"top\">\u25ba <strong>Hypertension<\/strong><\/td>\n<td width=\"22%\" valign=\"top\">\n<p align=\"center\">27.3<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">24.9<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">23.5<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"38%\" valign=\"top\">\u25ba<strong> Diabetes<\/strong><\/td>\n<td width=\"22%\" valign=\"top\">\n<p align=\"center\">9.0<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">8.2<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">11.3<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"38%\" valign=\"top\">\u25ba <strong>High Total Cholesterol<\/strong><\/td>\n<td width=\"22%\" valign=\"top\">\n<p align=\"center\">25.4<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">18.7<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">17.4<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"38%\" valign=\"top\">\u25ba <strong>Obesity<\/strong><\/td>\n<td width=\"22%\" valign=\"top\">\n<p align=\"center\">6.0<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">6.9<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">10.8<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"38%\" valign=\"top\">\u25ba <strong>Daily Smoking<\/strong><\/td>\n<td width=\"22%\" valign=\"top\">\n<p align=\"center\">15.2<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">12.6<\/p>\n<\/td>\n<td width=\"19%\" valign=\"top\">\n<p align=\"center\">14.3<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Source: <a href=\"https:\/\/www.moh.gov.sg\/content\/moh_web\/home\/statistics\/Health_Facts_Singapore\/Principal_Causes_of_Death.html\" target=\"_blank\" rel=\"noopener\">https:\/\/www.moh.gov.sg\/content\/moh_web\/home\/statistics\/Health_Facts_Singapore\/Principal_Causes_of_Death.html<\/a> (Last accessed 5th March 2015)<\/p>\n<p>Together with the common cough, cold and fever; <strong>hypertension, dyslipidaemia<\/strong> and <strong>diabetes<\/strong> mellitus are the top 4 reasons for the nearly <strong>4.7 million<\/strong> polyclinic attendances in Singapore each year. Statistically, this means that <strong>1 in 2<\/strong> who visit the <strong>polyclinic<\/strong> consult the doctor for either <strong>hypertension, diabetes, dyslipidaemia,<\/strong> flu or all of the above. Hence, regular blood pressure (BP) screening is vital for early detection.<\/p>\n<p style=\"text-align: center;\"><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/img.freepik.com\/free-photo\/nurse-measuring-blood-pressure-senior-elderly-woman-hospital-bed-patients-medical-healthcare-senior-concept_1150-21704.jpg?t=st=1668580808~exp=1668581408~hmac=4cd29d7fe5a6518c4034aec9e81971196ceba188e7da3bd7a5df8cb8c7379fd8\" alt=\"Nurse measuring blood pressure of senior elderly woman in hospital bed patients - medical and healthcare senior concept\" style=\"border-radius: 25px;\" width=\"852\" height=\"568\" class=\"\" \/><\/p>\n<p>Hypertension is defined as having a BP reading <strong>consistently<\/strong> above 140\/90mmHg. An <strong>ideal<\/strong> method of diagnosing hypertension is a 24-hour BP reading (ambulatory BP monitor). Most of the time, BP readings on 2 separate occasions <strong>above<\/strong> 140\/90mmHG are sufficient. Some patients <strong>only<\/strong> have high BP at the <strong>clinic\/hospital<\/strong>, and <strong>normal<\/strong> BP at <strong>other times<\/strong> of the day and place. They are referred to as having \u2018white coat hypertension\u2019 and <strong>do not<\/strong> generally <strong>require<\/strong> treatment. 24-hour BP monitors will be especially useful in such cases. (We have both BP measurement sets for sale and for loan in our clinic.)<\/p>\n<p>It is shown in large observational studies of <strong>up to<\/strong> 1 million individuals that cardiovascular risk <strong>increases<\/strong> with <strong>blood pressure<\/strong> in a <em>\u2018positive, strong, continuous, graded and predictive\u2019<\/em> manner.<\/p>\n<p>1. Deaths <strong>arising<\/strong> from cardiovascular diseases also <strong>increased linearly<\/strong> with <strong>blood pressure<\/strong> readings, with readings as low as 115mmHg (systolic) and 75mmHg (diastolic).<\/p>\n<p>2. It is for this reason that major bodies such as the 7th American Joint National Committee (JNC 7) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure <strong>introduced<\/strong> in 2004 a new classification with the term <strong>prehypertension<\/strong> to include those with blood pressures of between 120-139mmHg and 80-89mmHg. These individuals <strong>do not<\/strong> have a medical problem, and <strong>do not need<\/strong> treatment. But they are simply at <strong>risk<\/strong> of developing <strong>hypertension<\/strong> and require <strong>regular screening<\/strong>. JNC 8 released the latest guidelines on hypertension in 2014, largely <strong>refining<\/strong> the points on <strong>treatment<\/strong> of hypertension after taking into account results of newer studies.<\/p>\n<p style=\"text-align: center;\"><img decoding=\"async\" src=\"https:\/\/img.freepik.com\/free-photo\/elderly-woman-taking-medicine_53876-14961.jpg?t=st=1668580425~exp=1668581025~hmac=e446f91f1027dcafd67ec8f8019c6b747c4401503092424cf402a918fa8b4d3d\" alt=\"Elderly woman taking a medicine\" width=\"852\" height=\"568\" class=\"\" style=\"border-radius: 25px;\" \/><\/p>\n<p>A middle aged gentleman in his late 50s, who also was obese, had high cholesterol and was a heavy smoker asked me recently, <em>\u201cWhat are the <strong>risks<\/strong> and <strong>side effects<\/strong> of taking hypertension <strong>medications<\/strong> in the long run?\u201d<\/em><\/p>\n<p>I replied, <em>\u201cThe risks are <strong>not as high<\/strong>, and the side effects are <strong>not as bad<\/strong> as if you <strong>do not<\/strong> take them and continue to have a <strong>poorly controlled<\/strong> blood pressure in the long run.\u201d<\/em><\/p>\n<p>We will discuss about treatment in the subsequent issues.<\/p>\n<p>References:<\/p>\n<p><a href=\"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.0000132615.44103.B1\" target=\"_blank\" rel=\"noopener\">V. Franco, S. Oparil, OA. Carretero. Circulation 2004; 109: 2953- 2958. DOI: 10.1161\/01.CIR.0000132614.41493.B5<\/a><br \/>\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12493255\/\" target=\"_blank\" rel=\"noopener\">Lewington S, Clarke R, Qizilbash N, et al. Lancet 2002;360: 1903-1913<\/a><\/p>\n<p><em>Article contributed by Frontier Healthcare Clinical Content Team<\/em><\/p>\n<hr \/>\n<h2 dir=\"ltr\"><b>About Frontier Healthcare Group<\/b><\/h2>\n<p dir=\"ltr\"><span style=\"font-weight: 400;\">Frontier Healthcare (as part of the Qualitas Primary Care Division) runs 18 GP clinics, 2 <\/span><a href=\"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/\"><span style=\"font-weight: 400;\">Family Medicine Clinics<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/clinics\/clementi\/\"><span style=\"font-weight: 400;\">Clementi<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/clinics\/macpherson\/\"><span style=\"font-weight: 400;\">MacPherson<\/span><\/a><span style=\"font-weight: 400;\">) and has 37 affiliated GP clinics under its Frontier Primary Care Network Program. Frontier Healthcare supports national schemes such as the Community Health Assist Scheme (Pioneer, Merdeka, CHAS Green, CHAS Orange, CHAS Blue), Baby Bonus, <\/span><a href=\"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/healthiersg\/\"><span style=\"font-weight: 400;\">Healthier SG<\/span><\/a><span style=\"font-weight: 400;\">, MBS@Gov etc, as well as partnerships with major Insurers, Corporates and TPA partners to bring quality and affordable healthcare closer to the community.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Heart attacks\/diseases and strokes are commonly and collectively referred to as cardiovascular disease. <\/p>\n<p>Cardiovascular disease is a significant healthcare burden in Singapore. It contributed about 29.5% of the almost 19,000 deaths in 2013. This means that, 1 in 3 of us are likely to die from a heart attack, heart disease or stroke. If we exclude children and infants, this percentage will be even higher.<\/p>\n","protected":false},"author":1,"featured_media":1461,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[23],"tags":[],"class_list":["post-273","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-chronic-care"],"acf":[],"_links":{"self":[{"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/posts\/273","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/comments?post=273"}],"version-history":[{"count":0,"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/posts\/273\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/media\/1461"}],"wp:attachment":[{"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/media?parent=273"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/categories?post=273"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreepleasure.com\/__proxy_domain\/frontierhealthcare.com.sg\/wp-json\/wp\/v2\/tags?post=273"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}