Impact of New US Guideline of Defining High Blood Pressure
Ministry of HealthSpeakers
Summary
This question concerns Er Dr Lee Bee Wah's inquiry on the Ministry of Health’s stance regarding new US guidelines defining hypertension as 130/80 mmHg and efforts to raise awareness. Minister for Health Gan Kim Yong explained that Singapore maintains the 140/90 mmHg definition to align with global consensus, as adopting the more stringent US standard would double local prevalence to 43.2%. He noted that while both guidelines emphasize lifestyle changes, the ministry will continue monitoring clinical evidence regarding medication thresholds for individuals with cardiovascular risk factors. To address awareness, the Health Promotion Board promotes healthy habits and regular screening through various initiatives aimed at early detection. Furthermore, the Minister highlighted that subsidies under the Screen For Life program have been enhanced to encourage more citizens to manage their blood pressure effectively.
Transcript
55 Er Dr Lee Bee Wah asked the Minister for Health in light of the new US guideline defining high blood pressure as 130/80 mmHg (a) what percentage of our population falls within this category; (b) why is the Ministry not adopting this more stringent guideline; and (c) what is being done to raise awareness of hypertension as the 2010 National Health Survey indicates that one in four persons is not aware that they are hypertensive.
Mr Gan Kim Yong: The 2017 American Heart Association (AHA) and American College of Cardiology (ACC) guidelines have defined high blood pressure as 130/80 millimeters of mercury (mmHg) or higher.
However, the Ministry of Health (MOH) has decided to maintain its definition of hypertension as blood pressure 140/90 mmHg or higher in its Clinical Guidelines for Hypertension, after consulting local experts. This value remains the general consensus globally, supported by guidelines from societies, such as the International Society of Hypertension, the European Society of Cardiology and the National Heart Foundation of Australia. If Singapore adopted the new AHA guidelines, our hypertension prevalence would double from 21.5% to 43.2%4.
Despite the differences in definition, the management approach under the MOH's current and US' newly introduced definition is broadly similar. Under both sets of guidelines, all individuals with hypertension should change their lifestyles, whereas medication is recommended for hypertensive individuals with blood pressure higher than 140/90 mmHg. However, specifically for those with cardiovascular risk factors, the US guideline differs from the current general global consensus in recommending initiation of medication at a lower target of 130/80 mmHg, after an individual risk assessment. We will continue to monitor developments in this aspect and finetune our guidelines where necessary.
Hypertension can be effectively prevented through healthy lifestyle habits, such as maintaining a balanced diet and avoiding excess salt intake, regular physical activity and not smoking. For those with hypertension, screening and early detection will facilitate prompt treatment to achieve good health outcomes. The Health Promotion Board (HPB) has introduced many initiatives to encourage individuals to live healthily, as well as go for regular health screening under Screen For Life (SFL). The screening subsidies under HPB's SFL were recently enhanced.