Q: I am 50 years old and have had slight high blood pressure for the past 20 years. I'd like to know if it is all right for me not to be on medication. I prefer to take health foods or exercise for my condition.
Is there any health food or exercise that you can recommend? Is it safe for me to jog, skip or swim?
A: The prevalence of hypertension in Singapore is about 25 per cent based on the National Health Survey 2004. Its incidence increases with advancing age and nearly 50 per cent of the population at the age of 60 will have hypertension. All evidence has shown that the control of hypertension leads to a reduction in complications such as stroke, coronary heart disease, heart failure and death.
Treatment of hypertension requires a combined approach of lifestyle modification and pharmacological therapies.
Making changes lifestyle changes can delay the need for the use of drugs in those with mildly elevated blood pressure.
You can make these changes: Control your weight, increase physical activity, drink alcohol in moderation, restrict salt intake and increase your intake of dietary foods which are rich in calcium, potassium and magnesium. You should also try to manage stress management, stop smoking and stop taking any medicine known to elevate blood pressure such as antihistamines and steroids.
Studies have shown that the reduction of dietary sodium intake to less than 6g per day can achieve a modest reduction in blood pressure in hypertensive patients. None of the health supplements such as calcium, magnesium or potassium has ever been shown to produce any significant reduction in blood pressure.
When all the non-pharmacological measures fail, medication will be needed. In most hypertensive patients, pharmacological intervention becomes necessary if blood pressure reduction is to be substantial and sustainable.
Exercise is an important aspect of lifestyle change and is to be encouraged. However, exercise of moderate intensity is advised till blood pressure is optimally controlled.
Check with your doctor before embarking on any exercise programme. The risk of an adverse outcome is generally low.
Dr Eric Hong Cho Tek
Associate Consultant, Cardiac department
National University Hospital.
Reducing dietary sodium intake to less than 6g per day can help to reduce blood pressure in hypertensive patients.