Empowering hypertension patients to take charge of their health
MOH Office for Healthcare Transformation (MOHT)
Established in 2018 under the Ministry of Health, we seek to address issues affecting the lives & health of Singaporeans
In Singapore, the prevalence of hypertension rose from 24.2% in 2017 to 35.5% between 2019 and 2020, according to the National Population Health Survey 2020. We speak to three primary care doctors – Dr Wong Yi Lian (NUP), Dr Evonne Koh (NHGP) and Dr Leong Wai Siang (SHP) – who lead the Primary Tech-Enhanced Care (PTEC) programme in their respective polyclinics, to shed light on the ways we can take charge of our health and combat hypertension.??
What current trends have you been seeing in hypertension??
Dr Wong: Hypertension remains one of the most common chronic conditions amongst patients at the polyclinics. Lifestyle habits such as poor dietary control, being sedentary, smoking, as well as psychological stress can influence blood pressure control.??
Dr Koh: Hypertension has been on the rise in Singapore, with an uptick among young and obese individuals.??
Dr Leong: I have encountered many patients with newly diagnosed hypertension across all walks of life, from men serving National Service and office workers who have completed their health screening, to patients who have undergone a recent health assessment prior to an elective surgery. These patients commonly have co-morbidities like high body mass index, high cholesterol, sleep apnoea and blood glucose issues.?
What are the signs of pre-hypertension that people need to be aware of??
All: Hypertension is asymptomatic, hence there are no obvious signs to look out for. Although a patient with high blood pressure may experience giddiness or headaches, it is not common. Many cases of pre-hypertension and hypertension are only detected through blood pressure measurement, which is why hypertension is known as a “silent killer”.??
What would you say are the main challenges patients with high blood pressure face? ?
Dr Wong: To me, the main challenge they face is the lack of understanding about hypertension. Many patients are not aware of their own optimal target blood pressure control and assume that their blood pressure is well controlled as long as they are feeling well. This is not true. Also, do not assume that it is normal for your blood pressure to be higher if you are of an older age. Patients are given different targets for blood pressure control based on their age and comorbid conditions.??
Dr Leong: The main challenge, to me, will be patients’ lifestyle management. Healthy food is not always easily accessible in Singapore, and our Asian diet is very carbohydrate heavy. Many patients will need to go above and beyond their usual habits to manage their diet. In addition, many of my patients reported that they do not have the time or prefer to just relax over an episode of their favourite drama series instead of working out, even though they are aware of the benefits of exercise. Beyond healthy eating and staying active, patients have also highlighted pertinent concerns about side effects and phobia of medications.?
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What are the benefits of regular blood pressure monitoring??
Dr Koh: Regular blood pressure monitoring helps with:?
Dr Leong: Monitoring and charting blood pressure gives a wealth of information to both patients and physicians. For the patient, they can track the treatment progress to see if the lifestyle adjustment or medications are working. It also gives a sense of control over their blood pressure. For the physician, it allows better understanding and management of the patient’s condition.??
Any other tips we can practise at home to care for ourselves or those at risk of uncontrolled hypertension??
Dr Koh: I’ll recommend consuming a low-salt diet even if one does not have hypertension.?Regular exercise is also key in managing high blood pressure.
Dr Wong: Adopting a healthy lifestyle and taking medication go hand in hand in managing high blood pressure. Choose food with higher dietary fibre content and avoid high-salt food. Watch out for hidden sodium in sauces and gravy. In addition to dietary habits, engaging in regular physical activity and avoiding smoking also help with controlling blood pressure.??
Dr Leong: Each household should own a home blood pressure machine, which could be a lifesaver as hypertension is asymptomatic. Family members also play an important role in helping patients keep their hypertension under control. ?
PTEC – Telehealth for patients with hypertension ?
The Primary Tech-Enhanced Care (PTEC) programme is a collaborative effort by MOH Office for Healthcare Transformation (MOHT), NHGP, NUP and SHP, supported by Integrated Health Information Systems (IHiS), to empower patients to manage their chronic conditions from the comfort of their homes.?
Patients enrolled in the PTEC Home Blood Pressure Monitoring Programme monitor their blood pressure weekly and share these readings with their polyclinic. This programme enables hypertension patients to monitor their condition more closely with the help of timely and interactive advice from the PTEC app. It also allows for earlier interventions from the polyclinic when patients submit abnormal readings – for example, physicians may be able to adjust patients’ medications even before they come in for their next polyclinic visit.??
Since its launch in 2022, PTEC has enrolled more than 8,000 patients. Around half of PTEC patients show improved control of their blood pressure after six months.?
To learn more about PTEC, visit https://www.ihis.com.sg/VSM/home-bp-monitoring or call the IT Support hotline at 6958 7998.?