HYPERTENSION - MANAGEMENT

The first step to management is to make changes to your lifestyle, regardless of whether or not you require medication to control your hypertension. You should also work with your doctor to establish treatment goals.

LIFESTYLE CHANGES

• Weight reduction and regular aerobic exercise

• Reduced salt intake in diet

• Reduce and ideally stop smoking and alcohol consumption

• Reduce and manage stress

MEDICATION

Your doctor may prescribe medication to lower your blood pressure to a target level, based on your risk profile. These are the main types of blood pressure medication:

• Diuretics – help your body get rid of extra sodium and fluid

• Beta blockers – block the effects of adrenaline

• Alpha blockers – help your blood vessels stay open

• ACE inhibitors – block the production of angiotensin II, a chemical that constricts blood vessels

• Calcium channel blockers – prevent your blood vessels from constricting by blocking calcium from  entering the cells

• Angiotensin receptor blockers – similar to ACE inhibitors, except that they impede the action of angiotensin-II instead of stopping its production

HYPERTENSION - TREATMENT GOALS

In general, more stringent blood pressure control is required in diabetics and those with end-organ damage.

The Singapore Ministry of Health Clinical Practice Guidelines has recommended that optimal BP treatment target levels are < 130/85 mmHg in young, middle aged hypertensives and in patients with diabetes. For the elderly, the recommended target is < 140/90 mmHg.
It is worth noting, that with every 10 -14 mmHg reduction in systolic blood pressure, and 5 – 6 mmHg reduction in diastolic pressure, there is about a 40% reduction in stroke risk and a 14% reduction in coronary artery disease risk, although this risk reduction will vary with your overall risk profile.