​Singapore will not be adopting the new, stricter, high blood pressure definition of 130/80 that the American Heart Association has recommended.

It will continue to use the current 140/90 to indicate hypertension. This is also the value used in Europe and Australia, a Health Ministry spokesman said.
She added: "Essentially, while these new guidelines change the definition of hypertension for US patients, they do not change the approach to management in a major way."

This is because,despite the new cut-off, about 80 per cent of the newly defined hypertensives will not require any medication, but only lifestyle changes.

Based on the new definition, 46 per cent of Americans are now considered to have high blood pressure, up from 36 per cent.
She added: "Blood pressure can be kept in the healthy range by living a healthy lifestyle such as having a balanced diet, avoiding excess salt intake, having regular physical activity and not smoking."

Associate Professor Chin Chee Tang, a senior consultant from the Department of Cardiology at the National Heart Centre Singapore (NHCS), a member of the SingHealth group, said doctors have always known that the effects of blood pressure on health are a continuum, so thresholds for "normal'' or "not normal" are not always useful.

He said: "The lower the blood pressure is, the lower the risk of adverse outcomes. This has to be tempered with the increased risk of potential side-effects of treatment."

Assoc Prof Chin said the main advantage of the new US cut-off is it could raise awareness of the dangers associated with high blood pressure, and "be an earlier drive for individuals to optimise their blood pressure".

Dr Chia Shi Lu, head of the Government Parliamentary Committee for Health, said there was no reason as yet for Singapore or other countries to adopt the new standard, and that this was similar to the debate over the cut-off point for diabetes or cholesterol levels.

"These are all continuums, and a person doesn't suddenly tip over from being healthy to unhealthy at a particular point,'' he said.

Dr Chia, an orthopaedic surgeon at Singapore General Hospital, added that if Singapore adopted the new standard, many more people would be classified as hypertensive and this might lead to unnecessary treatment for many.

Like Assoc Prof Chin, he said it might also affect health insurance coverage, such as higher premiums to cover the additional risk, which might be "very little".

The 2010 National Health Survey found that 23.5 per cent of people here are hypertensive, with one in four not being aware of it.

More than half the people aged 60 years and older have high blood pressure.

The World Health Organisation says raised blood pressure is responsible for 7.5 million deaths a year, or almost 13 per cent of all deaths.

Ref: L20

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