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Health Education

Why High Blood Pressure Is Called the ‘Silent Killer’

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Hypertension, commonly known as high blood pressure, is referred to as the silent killer as there are no obvious symptoms to indicate that something may be wrong. How do we protect ourselves from this silent killer? Here are some facts about hypertension.


What is normal blood pressure?

Have you ever wondered what the two readings often quoted of your blood pressure are? The higher reading is the systolic blood pressure while the lower reading is the diastolic blood pressure.

The normal systolic blood pressure is less than 140 mmHg and the diastolic blood pressure less than 90 mmHg.


 Category  Systolic BP  Diastolic BP
 Normal BP  <130mmHg  <85mmHG
 High-normal BP  130 to 139 mmHg  85 to 89mmHg
 Hypertension ≥140mmHg ≥90 mmHg


How common is hypertension?

  • Based on Ministry of Health 2010 survey data1, prevalence of hypertension among Singapore residents aged 30 to 69 years old is 23.5%. Among those aged 18 to 69 years old, approximately 1 in 5 have hypertension.
  • It is also observed that hypertension is more common in those aged 40 and above. For example, among Singaporeans aged 60 to 69 years old, there are 7x more patients with hypertension than those aged 30 to 39 years old2.


What are some risk factors for hypertension? Can I reduce my risk by making certain lifestyle changes?

  • Modifiable risk factors include sedentary lifestyle, smoking, excessive drinking of alcohol, unhealthy diet, obesity
  • Non-modifiable risk factors include chronic kidney disease, diabetes mellitus, family history of hypertension and increasing age


What symptoms do hypertensive patients present with?

  • Usually there are no warning signs or symptoms3 and patients may generally feel normal
  • In Singapore, among those found to have hypertension in 2010, 26.3% had no previous diagnosis of hypertension1, which means that 1 in 4 patients do not know they have hypertension


Why is it important to treat hypertension?

  • Hypertension causes silent damage to organs such as the heart (increases the risk of a heart attack), brain (could lead to a stroke), eyes, chronic kidney disease and poor circulation in the lower extremities.
  • Below are some signs and symptoms to look out for:


  1. Heart attack symptoms
  • Chest pain
  • Shortness of breath


  1. Stroke symptoms
  • Difficulty in speaking or understanding speech
  • Sudden difficulty with movement or walking
  • Loss of balance or coordination


  1. Chronic kidney disease
  • Asymptomatic; first sign is usually protein in urine but knowledge of this can only be determined if there is a long-term follow-up with a healthcare provider


  1. Eye “stroke”
  • Sudden difficulty with vision


  1. Lower extremities
  • Pain in muscles of lower limbs with walking


What is a hypertension crisis?

  • Hypertension crisis is hypertension in a patient for which emergent medical care is required to prevent catastrophic complications of hypertension
  • It is defined as a systolic blood pressure greater than 180 mmHg OR a diastolic blood pressure of greater than 120 mmHg
  • It is important that individuals with such blood pressure readings seek immediate medical attention


How can I tell if I have hypertension?

  • Regular blood pressure monitoring will help you identify a possible hypertensive condition
  • Ways to monitor:
    • Use of a home blood pressure monitor
    • Take up the Singapore Health Promotion Board initiative, Screen for Life, which lets you consult a doctor and screen for chronic diseases at a subsidised cost


What can I do to better my health if I have been diagnosed with hypertension?

  • Lifestyle modification:
    • “Exercise is medicine”: maintain 150 minutes of moderately intense exercise (able to talk but unable to sing during the exercise) per week
    • Dietary: Following the evidence-based DASH diet, which is a formulated healthy eating plan consisting of the right balance of nutrients. Feel free to obtain more details from our Frontier family physicians or nurse educators if you are interested
    • Alcohol and smoking cessation
    • Weight management
    • Co-management with the doctor
      • Careful medication titration
      • Motivational talk
      • Surveillance for secondary complications of hypertension


If you have any question about hypertension, please speak to our friendly family physicians and nurses for more information.



  1. National Health survey 2010 MOH
  2. MOH clinical practice guidelines Nov 2017


 dr aw junjie

Dr Aw JunJie

Frontier Medical Associates (Ang Mo Kio)


Publication: 19th April 2020

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