Debated in Parliament on 8 Jan 2018.
Er Dr Lee Bee Wah asked the Minister for Health in light of the new US guideline defining high blood pressure as 130/80 mmHg (a) what percentage of our population falls within this category; (b) why is the Ministry not adopting this more stringent guideline; and (c) what is being done to raise awareness of hypertension as the 2010 National Health Survey indicates that one in four persons is not aware that they are hypertensive.
The 2017 American Heart Association (AHA) and American College of Cardiology (ACC) guidelines have defined high blood pressure as 130/80 millimeters of mercury (mmHg) or higher.
However, the Ministry of Health (MOH) has decided to maintain its definition of hypertension as blood pressure 140/90 mmHg or higher in its Clinical Guidelines for Hypertension, after consulting local experts. This value remains the general consensus globally, supported by guidelines from societies, such as the International Society of Hypertension, the European Society of Cardiology and the National Heart Foundation of Australia. If Singapore adopted the new AHA guidelines, our hypertension prevalence would double from 21.5% to 43.2%4.
Despite the differences in definition, the management approach under the MOH's current and US' newly introduced definition is broadly similar. Under both sets of guidelines, all individuals with hypertension should change their lifestyles, whereas medication is recommended for hypertensive individuals with blood pressure higher than 140/90 mmHg. However, specifically for those with cardiovascular risk factors, the US guideline differs from the current general global consensus in recommending initiation of medication at a lower target of 130/80 mmHg, after an individual risk assessment. We will continue to monitor developments in this aspect and finetune our guidelines where necessary.
Hypertension can be effectively prevented through healthy lifestyle habits, such as maintaining a balanced diet and avoiding excess salt intake, regular physical activity and not smoking. For those with hypertension, screening and early detection will facilitate prompt treatment to achieve good health outcomes. The Health Promotion Board (HPB) has introduced many initiatives to encourage individuals to live healthily, as well as go for regular health screening under Screen For Life (SFL). The screening subsidies under HPB's SFL were recently enhanced.
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