Hypertension, also known as high blood pressure, is highly prevalent. 

Around the world, an estimated 1.28 billion people worldwide suffer from high blood pressure (hypertension). 

In Singapore, according to the National Population Health Survey 2022, more than one in three Singaporeans aged between 18 to 74 years have high blood pressure (hypertension), with more males suffering from it than females (males 44%, females 30%).  

Normal blood pressure can vary from 90/60 mmHg to 120/80 mmHg in a young and healthy person. Hypertension is present when a person's blood pressure is persistently above 140/90 mmHg.

As a major risk factor for the development of cardiovascular disease, without appropriate management, hypertension can lead to complications such as:

• Stroke

• Ischaemic heart disease

• Heart failure and 

• Kidney damage

All these are associated with premature morbidity and mortality.

So take control of your blood pressure! Find out how by asking our specialist in this limited time forum.

About Dr Jonathan Ong

Dr Jonathan Ong is an Associate Consultant from the Department of Cardiology at National Heart Centre Singapore (NHCS). His clinical interest is in Electrophysiology and Pacing.

Questions and answers on preventing high blood pressure (hypertension)

1. Question by Jeffrey

Hi Doctor,

My blood pressure reading fall around 130/90 mmHg, is the reading consider acceptable? My age 59 now, I do exercise once a week playing casual soccer game for about 1-2hours. My Doctor is recommending me to start medication, I feel that I should not start so early. Can doctor advise me what should I do, so as to improve my blood pressure reading.

Hope to hear from you soon. Thank you.

Answer by Dr Jonathan Ong

Hi Jeffrey,

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. For both groups of patients, your doctor would perform an individualised cardiovascular risk assessment (taking into account risk factors and utilising risk assessment calculators) so as to set the appropriate BP target for each individual patient.

For patients with elevated BP, lifestyle intervention includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. 

Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients. 

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg 

2. Question by Emilia

Dear Dr Ong,

I am 42 yo and currently on high blood pressure medication. Initially it was ranging about 130/98 to 160/100

I took atenolol 100 mg and amlodipne 5 mg everyday. Nowadays, my blood pressure is ranging about 117/72 to 130/89. However, every time i did doctor checkup it never lower than 158/100 because I am anxious.

I do exercise as well to help lowering the BP. May I know if I eventually can off the medication?

Also, how do I know if this medication is not because a white coat syndrome because when i took the meds back in 2022, i was just checking the BP for a month and doctor diagnose me directly with BP and give meds without suggesting anything. Thanks.

Answer by Dr Jonathan Ong

Hi Emilia,

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. If one has persistent BP readings ≥140/90 mmHg on ≥2 occasions, one would be diagnosed with hypertension. For home BP readings, we use a cut off of ≥135/85 mmHg.

Home BP monitoring aids in ruling out white-coat hypertension. It is good that you monitor and record your home BP regularly as this BP trend aids your doctor in further management. Discussions on possibly reducing medication doses or discontinuing medication can also be had then with him/her.

3. Question by Jimmy

Dear Dr Jonathan Ong,

Besides going for walks clocking 10,000 steps, drinking coffee without sugar, avoiding salt intake, how else should I do to ensure that my hypertension is under control?

I have also intentionally lost 10kg but it seems not possible to reduce any further although I have only two meals a day to try to reduce my weight. Thank you.

Answer by Dr Jonathan Ong

Good job on taking charge of your health and taking active steps to stay healthy! Keep it up!

For patients with elevated BP, lifestyle intervention includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

4. Question by Kok Meng

Dear Dr Ong

What is the normal range of blood pressure for a 70-year-old man and when is medication needed? Thank you.

Answer by Dr Jonathan Ong

Hi Kok Meng,

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. For both groups of patients, your doctor would perform an individualised cardiovascular risk assessment (taking into account risk factors and utilising risk assessment calculators) so as to set the appropriate BP target for each individual patient.

During that assessment, it is indeed true that age is one of the considerations. In the elderly, one might consider less stringent BP targets - <150/90 mmHg.

For your further reading, read this article: High Blood Pressure: Understanding Blood Pressure Readings - HealthXchange

After diagnosing hypertension and setting the individualised BP target, lifestyle intervention is indicated. This consists of a healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. 

Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

Depending on the BP at diagnosis, your doctor might prescribe lifestyle intervention alone first or combine it with medication upfront. If the BP target is not achieved with lifestyle intervention alone, medication is indicated.

5. Question by Elaine

Hi Dr Ong,

I am on medicine for 2 years. I gotten high blood after I became overweight.

If I lose weight, it should be back to normal. May I ask how do I know if I can slowly wean off the medicine? Thanks.

Answer by Dr Jonathan Ong

Hi Elaine,

For patients with elevated BP who are overweight, weight reduction does play a role in reducing it. Other important lifestyle interventions include healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity and smoking cessation.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

With respect to weaning off medications, it'll be best to do this hand in hand with your family physician who is taking care of you. 

Discussions on this can be had with him/her after reaching a healthy weight range and depending on your BP trend then, it might be an option.

6. Question by Lynette

Dear Dr. 

I have slight hypertension. my BP is always between 130/90 .. Sometimes it can be very high at 150/90.

I weigh 49kg and my height is 153cm, and my age is 53. So I am not overweight.

I exercise (jogging) 3 times a week. I don't drink nor smoke. I eat only home cooked food.

There are no family members who are also having hypertension.

What else can I do to keep my BP in control?

Answer by Dr Jonathan Ong

Hi Lynette,

For patients with elevated BP, lifestyle intervention includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. 

Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

Good job on having done all of the above! Keep it up! 

If, however, one's BP is still inadequately controlled after 3-6 months of lifestyle intervention, medication should be considered, do consider discussing this with your family physician.

7. Question by Ron

Dear Dr. Jonathan,

I am seeking your advice on managing and controlling high blood pressure.

Could you provide insights on:

a) Effective lifestyle and dietary changes.

b) Recommended exercises for people aged 40 to 70.

c) When medication is recommended and if it is needed for life.

d) Preventative measures to avoid hypertension.

Thank you for your assistance.

Answer by Dr Jonathan Ong

Hi Ron,

For patients with elevated BP, lifestyle intervention includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. 

Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

Depending on the BP at diagnosis, your doctor might prescribe lifestyle intervention alone first or combine it with medication upfront. If the BP target is not achieved with lifestyle intervention alone, medication is indicated.

8. Question by Cara

Hi Dr Ong,

For a 52-year-old male with BP of 130-140/90-100, many doctors said that it is within normal range, what do you think?

This person exercises regularly, does not smoke but loves to drink beer. On an average, he drinks 1-2 pints a day, is this acceptable given his BP?

Any other advice you would give to this person? Thank you.

Answer by Dr Jonathan Ong

Hi Cara,

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. 

For both groups of patients, your doctor would perform an individualised cardiovascular risk assessment (taking into account risk factors and utilising risk assessment calculators) so as to set the appropriate BP target for each individual patient.

For patients with elevated BP, lifestyle intervention includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. 

With respect to alcohol consumption, HPB recommends that men should drink no more than two standard drinks a day, and women should drink no more than one. A standard drink refers to 2/3 of a small can of regular beer (220ml), a small glass of wine (100ml) or one nip of spirit (30ml). 

Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

9. Question by Sanford

Dear Dr,

What can patients with high blood pressure do on a regular basis to lower their blood pressure such that they can eventually wean themselves off prescription medication such as Losartan, Nifedipine etc?

Answer by Dr Jonathan Ong

Hi Sanford,

For patients with elevated BP, lifestyle intervention is recommended. This includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation. Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

With respect to weaning off medications, it'll be best to do this hand in hand with your family physician who is taking care of you. Discussions on this can be had with him/her and depending on your BP trend, it might be an option.

10. Question by Merry

Dear Dr,

I am a female, 47 years old, non-smoker. With tract record of high LDL and family background of heart disease and high cholesterol.

Last year my BP is quite high around 130-150, thus prescribed to take ambilon 5mg daily.

Now, my BP is around 110 - 130 (test on morning and evening)

Do I still need to take medicine daily? How could I know whether I still should take the medicine or I can stop taking the medicine

Appreciate your kind suggestion. Thank you.

Answer by Dr Jonathan Ong

Hi Merry,

Your BP is now well controlled on medication. Do continue to take it regularly as prescribed and attend your regular follow ups with your family physician. Keep it up!

11. Question by Yurt Wah

Dear Dr,

I am a 72-year-old female. Since 2016 to May 2024, my systolic blood pressure is around 100 or less while my diastolic blood pressure is around 50-60. Sometimes it even dropped to below 50.

On 4 May 2024, I had a viral infection causing me to have a sore throat, cough, phlegm and vertigo.

My blood pressure was 119/64 on 4 May and 134/76 on 5 May. After about a week, my systolic blood pressure is below 120 while my diastolic blood pressure is around 65. I no longer suffer from vertigo.

My GP told me that I may get vertigo when I am sick. I would like to know the possible reasons for the increase in blood pressure after so many years of low blood pressure. Thank you very much.

Answer by Dr Jonathan Ong

Hi Yurt Wah,

It is likely that your blood pressure differed from your baseline during that period due to your acute illness. Normal blood pressure can vary from 90/60 mmHg to 120/80 mmHg in a healthy person and this explains why your readings fall and vary within that range. Blood pressure doesn’t stay constant throughout the day and can be affected by many factors – activity, emotions, etc.

For your further reading, read this article: High Blood Pressure: Understanding Blood Pressure Readings - HealthXchange

12. Question by Ron

Dear Dr,

I am under medications, avg 108/80 .. is there ANY way to wean off medication with better food control, exercise and controlled HDL/LDL cholesterol, Triglycerides etc via Simvastatin? (can this be weaned off too)

What are the safe methods available monitor weaning off?

Answer by Dr Jonathan Ong

Hi Ron,

It’ll be best to do this hand in hand with your family physician who is taking care of you. He/she would determine how well your BP is being controlled and depending on your BP trend, it might be an option.

13. Question by Dawn

Hi Dr Ong,

I am a 52 years old Singaporean female & I came from a family with history of hypertension & heart diseases. I had hypertension for more than 20 years but I did not diligently take medication.

I am aware of the health risk & I would like to seek consultation with a clinic/hospital who is able to provide long term mgt of my hypertension with some govt subsidy as I am currently unemployed. Pls advise which clinic / hospital I could go. Thank you.

Answer by Dr Jonathan Ong

Hi Dawn,

You can seek consultation at any of our government polyclinics. Advise on subsidies/financial aid can be sought there concurrently as well.

14. Question by Surayah

Dear Dr Jonathan Ong

I like to know whether by exercising (example Qiqong and slow chair Zumba) can it help in lowering down high blood pressure?

Can I take my high blood pressure medication on alternate days? Will It affect my health?

And can I know how can I reduce fat in the liver?

Answer by Dr Jonathan Ong

Hi Surayah,

For patients with elevated BP, lifestyle intervention includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

Medication should be taken as prescribed to achieve their desired effects and intent as every drug has a different duration of action. Taking it only half the time would result in you being off treatment half the time which would not be ideal.

15. Question by Yok Ling

Dear Dr Ong,

I am 75 years old & I have been taking high blood pressure medicines for about 20 years.  Other than taking high blood pressure tablets I am also taking thyroxin for my thyroid. 

I would like to ask you a question that can I slowly stop taking my medicine if my high blood pressure is now under control with the reading of 130/80?  I will also continue to monitor my high blood pressure if I slowly stop taking my medicine. Thank you.

Answer by Dr Jonathan Ong

Hi Yok Ling,

It’ll be best to do this hand in hand with your family physician who is taking care of you. He/she would determine how well your BP is being controlled and depending on your BP trend, it might be an option. It is not advisable to do it yourself.

16. Question by Mokky

Hello Dr Jonathan Ong

I’ve been diagnosed with mild hypertension since my early 40s and been on medication of 2.5mg amlodipine duly for over 10 yrs. Last year the dosage was increased to 5mg as I reached my mid 50s and starting showing signs of higher blood pressure following menopause. 

My BP is well managed again now circa mid 120/high 70 to low 80.  I’m also exercising more regularly now and have managed down my weight to a BMI which is now within range.

Can I reduce the medication again back to 2.5mg? Thank you for your advice.

Answer by Dr Jonathan Ong

Hi Mokky,

It’ll be best to do this hand in hand with your family physician who is taking care of you. He/she would determine how well your BP is being controlled and depending on your BP trend, it might be an option. It is not advisable to do it yourself.

17. Question by Michael

Dear Dr Ong

I'm 75 years old and have just been diagnosed with Stage 1 high blood pressure. My doctor has recently started me on medication.

I've read that medication is often a 'forever' commitment. Along with this, individuals could suffer side effects due to the medicine.

Is there a chance that, if my HBP stabilizes, I could eventually stop taking the medication? Thank you.

Answer by Dr Jonathan Ong

Hi Michael,

Besides taking your medication, lifestyle intervention is also indicated to decrease your blood pressure. This includes healthy diet (e.g. reducing sodium intake and alcohol consumption), increased physical activity, weight reduction if overweight or obese, and smoking cessation.

Benefits of lifestyle intervention extend across age groups and cardiovascular risk levels and are therefore encouraged for all patients.

For your further reading, read this article: High Blood Pressure (Hypertension): 8 Ways to Lower Without Medicine - HealthXchange.sg

During regular follow ups with your family physician, he/she would determine how well your BP is being controlled on both lifestyle intervention and medication and depending on your BP trend, it might be an option to eventually stop taking the medication.

18. Question by Ron

Dear Dr,

I get varying blood pressure readings for the high readings every day I checked.

Sometimes above 150...otherwise just 138. My lower BP stays around 81.

Noticed heart rate is low when readings are high. Is there a concern? I’m not keen to starts on statin. Please advise.

Answer by Dr Jonathan Ong

Hi Ron,

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. 

Based on your readings, I’ll advise seeing your family physician with your home BP record. He/She will then set the appropriate BP target for you and institute measures to reach it – lifestyle intervention and possibly medication if indicated upfront.

19. Question by Gayatri

Dear Dr,

How do I distinguish if I have a blood pressure issue or White Coat Syndrome? Also, blood pressure when taken manually by a Dr, is it better than by the automated system? Thanks.

Answer by Dr Jonathan Ong

Hi Gayatri,

Home BP monitoring aids in ruling out white-coat hypertension. Monitoring and recording your home BP regularly and reviewing that trend with your doctor aids him/her in further management. Both properly taken automated and manually taken BP readings can be used for hypertension diagnosis and management.

20. Question by Peter

Hi Dr Ong

I am approaching 70 years of age.  I am taking medication for hypertension for many years. Recently I started to go to polyclinic for management of my cholesterol and hypertension problems and was surprised to note that my blood pressure should be around 175/75 against 180/90 mark that the private clinics wanted me to maintain. Why is this so?

Also, early this year the diastolic readings then were higher - between 90 and 100. Is this of concern?

Answer by Dr Jonathan Ong

Hi Peter,

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. A blood pressure of 175-180/75-100 would definitely thus be considered high. 

Your doctor at the polyclinic would perform an individualised cardiovascular risk assessment (taking into account risk factors and utilising risk assessment calculators) so as to set the appropriate BP target for you and institute measures to achieve it. Do continue long term follow up with him/her so as to adequately control your hypertension.

21. Question by Dave

Dear Dr,

I used to have high blood pressure. After two years of medication, it has stabilised to normal 120/80.

I exercise quite regularly and eat properly as recommended.

I would really like to know if it is ever safe to stop taking medicine?

As I don’t want to be taking medicine forever. Is that possible?

What questions should I ask my doctor, and what positive indications should he and I look out for.

Hope you can advise as a Heart Specialist. Thank you.

Answer by Dr Jonathan Ong

Hi Dave,

Good job on taking charge of your health and taking active steps to stay healthy! Keep it up!

With respect to weaning medications, it’ll be helpful if you could monitor and record your home BP regularly as this BP trend would aid your primary physician in further management. Discussions on possibly reducing medication doses or discontinuing medication can also be had then with him/her.

22. Question by Ms Carol

Hi Dr Jonathan

My BP reading has been very constant for the past 10 over years with reading in the range of 110/70 to 120/79. (Exception is when I am not well).

I am on the lowest dosage of 2.5mg Bisoprolol one table every morning.

Is there a possibility of reducing my medication further? On alternate days instead of daily? Will there be a risk?

Answer by Dr Jonathan Ong

Hi Carol,

With respect to weaning medications, it’ll be helpful if you could monitor and record your home BP regularly as this BP trend would aid your primary physician in further management. Discussions on possibly reducing medication doses or discontinuing medication can also be had then with him/her.

There might also be other reasons you are on Bisoprolol as well other than hypertension. Your primary physician would be able to advise you at that point with respect to what these other reasons are.

23. Question by Anne

Dear Dr Ong,

I am on 40mg (half tab of 80mg Valsartan) daily, my age is 63 and I have been taking this medicine for the past 2 years.

However, I noted each time my reading from left arm is very different from the right arm. (E.g. right side 124 79 68, left 134 83 71) Sometimes right is higher whilst left is lower and vice versa. Is it a concern?

I noted also morning reading is high whilst evening is within healthy range.

Sample of reading as follows:

morning 147 98 68
night 137 95 76

Please advise. Thank you for your kind attention.

Answer by Dr Jonathan Ong

Hi Anne,

Blood pressure doesn’t stay constant and can be affected by many factors – activity, emotions, how it’s taken, etc. This explains the difference in your blood pressure readings.

For your further reading, read this article: High Blood Pressure: Understanding Blood Pressure Readings - HealthXchange

A clinic BP reading of ≥130-139/85-89 mmHg is high-normal BP while a clinic BP reading of ≥140/90 mmHg is hypertension. 

If one has persistent BP readings ≥140/90 mmHg on ≥2 occasions, one would be diagnosed with hypertension. 

For home BP readings, we use a cut off of ≥135/85 mmHg. As the readings you’ve provided are above that cut off, I’ll suggest monitoring and recording your home BP regularly twice a day and providing that BP trend to your primary physician for further management.

Ref: H24