High Blood Pressure (Hypertension)

Medically reviewed by Dr Reginald Liew – The Harley Street Heart & Vascular Centre. Last reviewed: August 2026

Key Facts

• About 1 in 3 adults in Singapore aged 18–74 has high blood pressure - 33.8% in 2023–2024 (MOH National Population Health Survey 2024).
• High blood pressure is usually silent - most people have no symptoms - which is why regular measurement matters.
• Left untreated, it raises the risk of heart attack, stroke and kidney disease.

Overview

High blood pressure, known medically as hypertension, means that the force of blood pushing against the walls of the arteries is consistently raised. Blood pressure naturally rises and falls throughout the day in response to activity, stress and sleep, but in hypertension it stays elevated over time. The sustained extra pressure makes the heart work harder and gradually places strain on the arteries and on organs such as the brain, kidneys and eyes. Over months and years this can increase the risk of heart attack, heart failure, stroke, kidney disease and other problems.

Hypertension is common, and its frequency rises with age. In Singapore, as in many places, a large number of adults are affected, and a proportion of them are unaware of it because the condition often produces no symptoms. Understanding what blood pressure is, how it is measured and what can be done about it is an important part of looking after long-term heart and blood-vessel health.

How blood pressure is measured

Blood pressure is recorded as two numbers. The first (systolic) reflects the pressure when the heart contracts, and the second (diastolic) reflects the pressure when the heart relaxes between beats. The reading is usually taken with a cuff placed around the upper arm, either by a healthcare professional or with a validated home device.

A single raised reading does not, on its own, confirm hypertension. Blood pressure varies from moment to moment, and readings can be temporarily elevated by recent activity, caffeine, a full bladder, talking, or simply the anxiety of being in a clinic, sometimes called the "white-coat" effect. For this reason, a diagnosis usually rests on several readings taken on different occasions and, where appropriate, on measurements taken outside the clinic.

• Home blood pressure monitoring uses a validated upper-arm device to record readings over a period of days, typically morning and evening, in a calm setting.
• 24-hour ambulatory monitoring uses a device worn for a day that takes readings at intervals, including during sleep, giving a picture of blood pressure across normal daily life.

Taking readings while seated and rested, with the arm supported and the back supported, and avoiding caffeine or exercise beforehand, helps produce results that are more representative.

Symptoms

Hypertension is usually silent - most people feel completely well and have no warning signs. This is why it is sometimes described as a "silent" condition, and why regular measurement matters even when a person feels healthy. Because there are often no symptoms to prompt a check, hypertension can be present for years before it is detected.

Very high readings can occasionally be associated with headache, breathlessness, nosebleeds or visual disturbance, but these are not reliable indicators and most people with raised blood pressure notice nothing at all. Symptoms should therefore never be relied upon to judge whether blood pressure is controlled; measurement is the only dependable way to know.

Causes

• Primary (essential) hypertension - by far the most common form, it develops gradually over years and has no single identifiable cause. It is thought to arise from a combination of genetic predisposition, ageing of the blood vessels and lifestyle factors.
• Secondary hypertension - less common, this is raised blood pressure caused by another underlying condition. Possible contributors include kidney disease, hormonal disorders affecting glands such as the adrenal or thyroid glands, obstructive sleep apnoea, and certain medicines or substances. Secondary causes are sometimes considered when hypertension appears at a younger age, is unusually difficult to control, or develops suddenly.

Risk factors

A number of factors are associated with a higher chance of developing hypertension. Some cannot be changed, while others relate to lifestyle and may be modifiable.

• Older age and a family history of high blood pressure
• Excess weight and physical inactivity
• A diet high in salt
• Drinking alcohol in excess
• Smoking
• Diabetes
• Obstructive sleep apnoea

The presence of one or more risk factors does not mean a person will certainly develop hypertension, but it does make regular checks more important.

Complications

When blood pressure remains raised over a long period, the steady strain on the heart and arteries can contribute to serious conditions affecting several organs.

• Heart attack and heart failure
• Stroke
• Kidney disease, including reduced kidney function over time
• Vision problems caused by damage to the small blood vessels in the eyes

Because much of this damage builds up quietly, controlling blood pressure aims to lower the long-term risk of these outcomes rather than to relieve day-to-day symptoms.

Prevention

Many of the same measures that help treat hypertension can also reduce the chance of developing it. These steps support general heart and blood-vessel health and are relevant to everyday life in Singapore.

• Reducing salt intake, which may include being mindful of salt in hawker dishes, sauces, processed foods and seasonings
• Eating a balanced diet with plenty of vegetables and fruit
• Taking regular physical activity
• Reaching and maintaining a healthy weight
• Limiting alcohol
• Not smoking

Small, sustained changes are generally more useful than short-lived efforts, and they can be discussed with a doctor in the context of a person's overall health.

Diagnosis

Diagnosis is based on repeated, properly measured readings rather than a single value, and it is sometimes confirmed with home or 24-hour ambulatory monitoring to account for normal variation and the white-coat effect. A doctor will usually also ask about symptoms, lifestyle, family history and other medical conditions.

Further tests may be arranged to look for possible underlying causes and to assess whether raised blood pressure has had any effect on the heart, kidneys, eyes or other organs. These can include blood and urine tests, an electrocardiogram (ECG) and other investigations as appropriate to the individual.

Treatment

Treatment is tailored to the individual and usually combines lifestyle measures with medicines where these are needed. The aim is to bring blood pressure into a suitable range and to reduce the long-term risk of complications.

• Lifestyle measures - adjustments to diet and salt intake, regular physical activity, weight management and limiting alcohol form the foundation of treatment and may be sufficient for some people, particularly when blood pressure is only mildly raised.
• Medicines - several classes of approved oral medicines are available, and these are often used in combination at lower doses to improve control. The commonly used groups act in different ways, for example by relaxing or widening blood vessels, by reducing the volume of fluid the body holds, or by influencing hormonal systems that regulate blood pressure. The choice depends on a person's age, other conditions and how they respond, and is decided with their doctor.
• Adherence - because hypertension is usually a long-term condition with few symptoms, taking medicines consistently as prescribed and attending follow-up appointments are important for keeping blood pressure controlled over time.
• Emerging options - longer-acting injectable therapies are being studied in clinical trials but are not yet standard care (see: Injectable Treatments for High Blood Pressure (/kb/treatments/injectable-hypertension-treatments/))

Treatment is not usually a one-off event; doses and combinations may be reviewed and adjusted over time, and lifestyle measures remain valuable alongside any medicines.

When to see a doctor

Have your blood pressure checked regularly, even when you feel well, as this is often the only way hypertension is detected. See a doctor if your readings are persistently raised, or if you are unsure how to interpret home readings.

Seek urgent assessment for severe symptoms such as chest pain, severe or sudden headache, breathlessness, weakness or numbness on one side of the body, difficulty speaking, or visual disturbance, as these may indicate a serious problem that needs prompt attention.

Frequently Asked Questions

Does high blood pressure cause symptoms I would notice?

Usually not. Most people with hypertension feel well, which is why regular measurement is important even in the absence of any symptoms.

Can I tell my blood pressure is fine because I feel healthy?

No. Feeling well does not confirm that blood pressure is controlled. The only dependable way to know is to measure it.

Is one high reading enough to diagnose hypertension?

Not on its own. Blood pressure varies, and readings can be temporarily raised. A diagnosis usually rests on several readings on different occasions, sometimes supported by home or ambulatory monitoring.

Do lifestyle changes really make a difference?

Lifestyle measures such as reducing salt, staying active, managing weight and limiting alcohol are an important part of managing blood pressure, and for some people they may reduce the need for medicines. They are worth discussing with a doctor.

Will I need to take medicine for the rest of my life?

This varies from person to person. Some people manage with lifestyle measures, while others need long-term medicines. A doctor can review treatment over time and adjust it as needed.

Related reading: Injectable Treatments for High Blood Pressure; Longevity & Healthspan

Medical Resources & References

• Mayo Clinic - High blood pressure - https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
• Singapore Heart Foundation - High blood pressure - https://www.myheart.org.sg/health/risk-factors/high-blood-pressure/
• MOH - National Population Health Survey 2024 - https://www.moh.gov.sg/others/resources-and-statistics/national-population-health-survey–nphs–2024-report/