How the Kidneys work – A brief Physiology

Every cell of the human body requires a specific set of conditions for proper functioning, of which the balance of electrolytes, pH and concentrations of certain molecules has prime importance. In turn, every living cell contributes to a change in these parameters by producing various molecules, hormones and waste products. An optimal set of conditions is maintained by the organs of homeostasis, of which the kidneys are the main foundation.

The kidneys have an intricate network of tubules and blood vessels. Waste products (like urea and creatinine) and certain essential blood-borne chemicals are filtered out into these tubules. As the filtrate fluid moves down these tubules, water and other essential elements are reabsorbed to maintain body homeostasis. The remaining fluid of the tubules containing the waste products is ultimately excreted out as urine.

The kidneys also produce hormonal responses relating to maintaining blood pressure, red blood cell production and activation of vitamin D.

Types of Kidney Disease

Kidney diseases are primarily classified into the following types:

• Infective – Urinary tract infections and pyelonephritis (infection of the kidney) result from retrograde movement of bacteria through the urinary tract. These are treated by hydration, antibiotics and other conservative measures.
• Renal Failure – Most often resulting from chronic diseases and acutely from toxins, drugs or IV contrast. Result in a rise in blood urea and creatinine. Dialysis is often required in these conditions.
• Kidney stones – May pass in the urine on their own by hydration, dietary modification or other conservative measures. Otherwise, surgical removal or lithotripsy is sought.
• Kidney diseases having protein loss in urine – These are nephrotic or nephritic syndromes and involve damage to the glomeruli. Medications are often effective.

Ways to keep your Kidneys healthy

• Manage Chronic Diseases – Most of the common chronic diseases such as hypertension, diabetes mellitus and heart diseases often lead to a progressive failure of kidneys. Such diseases should be kept in check with regular visits to your healthcare provider and being compliant with the management.
• Maintaining a healthy diet and hydration – Avoiding excess salts and proteins, especially in the setting of failing kidneys is essential. Hydration also helps prevent certain kidney stones and infections.
• Regular physical exercise – of about 30 minutes on most days of the week.
• Get enough sleep – helps manage stress hormones and the resulting damage from their excess. 7 to 8 hours of sleep is recommended every night.
• Quit smoking and excessive drinking.

In short, maintaining a healthy kidney is a necessity for healthy living since it is a vital organ of our body and failure to do so may result in the decline of well-being.  Visit your healthcare provider for your regular blood and renal function tests to find out about the health of your kidneys.

Disclaimer: 

All content in this publication is for informational and educational purposes only. It does not constitute any form of medical advice or clinical care nor is it intended to be a substitute for professional medical care. Please speak to your healthcare provider if you have any questions pertaining to your healthcare.

References

1. Dalal R, Bruss ZS, Sehdev JS. Physiology, Renal Blood Flow and Filtration. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482248/
2. https://www.ajkd.org/article/S0272-6386(13)00590-8/fulltext#secd109855982e235 
3. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/prevention
   

Taking Control of Your Health: Managing High Cholesterol in Singapore

Living in Singapore, known for its bustling energy and vibrant culinary scene, it’s easy to let health concerns slip down the priority list. However, one silent yet significant factor can be lurking beneath the surface – high cholesterol. This waxy substance, while essential for our body’s functions, can turn into a silent threat when its levels climb too high.

Why Should You Care about Cholesterol?

Cholesterol itself, at health levels, isn’t bad. It plays an important role in building cell membranes, hormones and even vitamin D. However, the trouble arises when the “bad” type of cholesterol, like LDL (low-density lipoprotein), accumulates in your body. These substances will be deposited in your vessels, affecting the blood flow. This, in turn, increases the risk of developing cardiovascular diseases like heart attack, stroke and peripheral artery disease.

Testing Your Cholesterol

Knowing your cholesterol levels is the first step to taking control. Regular cholesterol screenings with your healthcare provider, in adherence to the national screening guidelines, aids in early detection and intervention. Your doctor can interpret your results and advise on the best course of action.

Conquering Cholesterol: A Roadmap to a Healthier You

The good news is, that managing high cholesterol can start with small steps. Here are some practical tips you can incorporate into your Singaporean lifestyle:

1. Embrace a Heart-Healthy Diet:

• • Say no or cut down on saturated and trans fats: Fatty meats, fried foods and processed snacks are loaded with these. Lean and healthier protein sources like fish and chicken breast can be chosen instead.
  • Fill your plate with fibre: Fruits, vegetables, and whole grains are great alternatives.

2. Move Your Body, Regularly with Healthier SG:

• • Physical activity is important in achieving healthy cholesterol levels. Engage in physical activity that is suitable for your age group, fitness levels and medical issues. Speak to your healthcare provider to find out more about what is suitable for you.

3. Maintain a Healthy Weight:

• • Excess weight and obesity may result in high cholesterol levels. Losing weight can help one improve their cholesterol levels and overall health. To find personalised weight management strategies that work for you, consider speaking with your doctor or a registered dietitian who can provide professional guidance and support.

4. Partner with Your Doctor:

• • It’s important to have regular checkups so you can keep tabs on your cholesterol levels. That way, you can stay on top of your treatment plan and make any necessary adjustments. If you have any concerns or questions, don’t hesitate to talk to your doctor about them. They’re there to help you and will be delighted to answer any questions.

Remember, managing high cholesterol is a marathon, not a sprint. By making small, sustainable changes to your lifestyle and partnering with your healthcare team, you can take control of your cholesterol and pave the way for a healthier, happier you.

Commit to your heart health today! Schedule a cholesterol screening with your doctor, visit the MHC clinic for personalised guidance and support, and join the growing community of Singaporeans living heart-healthy lives. Together, we can raise awareness and conquer high cholesterol, one step at a time!

Let MHC be your Healthier SG navigator. Enjoy personalised health plans, expert advice, and a dedicated care team by your side, all within the convenient Healthier SG framework.

Facts about Diabetes Mellitus: Key Information for Health-Conscious Individuals

Diabetes Mellitus (DM) is a chronic condition that affects how your body utilises blood sugar (glucose) for energy. It’s a prevalent health issue in Singapore. Uncontrolled, it can lead to a cascade of complications that significantly impact your health and well-being.

While there are multiple types, the common ones in Singapore are Type 1, Type 2 and gestational diabetes.

Understanding the Different Types of DM

While there are multiple types, the common ones in Singapore are Type 1, Type 2 and gestational diabetes.

• Type 1 DM: The body’s immune system attacks insulin-producing cells, resulting in insufficient insulin production.
• Type 2 DM: The body either doesn’t produce enough insulin or becomes resistant to its effects, leading to high blood sugar levels.
• Gestational DM: Develops during pregnancy.

Recognising the Risk Factors

Resources:

• National diabetes statistics report, 2022. Centers for Disease Control and Prevention. Updated January 18, 2022. Accessed August 4, 2022. www.cdc.gov/diabetes/data/statistics-report/index.html
• Prevalence of prediabetes among adults. National diabetes statistics report, 2022. Centers for Disease Control and Prevention. Updated September 30, 2022. Accessed November 1, 2022. www.cdc.gov/diabetes/data/statistics-report/prevalence-of-prediabetes.html

Maintaining Bowel Health: Tips for Health-Conscious Singaporeans

Eating isn’t just a delightful experience that tantalizes our taste buds; it’s a cornerstone of well-being, providing essential nutrients that fuel our bodies and invigorate our vital organs. The profound connection between what we consume and how our bodies thrive makes nurturing a healthy digestive system a top priority, accomplished through mindful food choices and sensible eating practices.

Simple Strategies for Wellness

A few fundamental principles can make a difference when embracing a lifestyle that supports optimal digestive health. Here’s how you can take charge of your digestive well-being:

1.  Embrace the Fibre Revolution: Fuel your body with the goodness of high-fibre foods – a cornerstone of digestive health. Incorporating various fruits, vegetables, whole grains, and legumes into your diet ensures a seamless digestion process. Fibre not only prevents constipation but also bolsters a healthy weight. Furthermore, it protects against diverticulosis, irritable bowel syndrome (IBS), and haemorrhoids.
2. The Fibre Symphony (Soluble and Insoluble): Dive into the world of fibre’s dual prowess – soluble and insoluble. Insoluble fibre in vegetables and whole grains adds bulk to your stools, facilitating smooth movement through your digestive tract. On the other hand, soluble fibre, found in foods like oat bran, nuts, and legumes, attracts water and prevents overly liquid stools.
3. Balance Fat Intake: While fat plays a role in your diet, opt for moderation and balance. High-fat foods can slow down digestion, potentially leading to discomfort. Pairing fats with high-fibre counterparts can aid in smoother digestion. Lean meat, such as skinless poultry and pork loin, provides essential protein without overburdening your digestive system.
4. Cultivate a Probiotic Haven: Unlock the potential of probiotics, the tiny warriors that mirror the healthy bacteria residing in your gut. Probiotics are guardians of your overall well-being in a world of dietary challenges, antibiotics, and stressors. These microorganisms can enhance nutrient absorption, tackle lactose breakdown, shield against IBS, and fortify immune defences. Nourish your gut with probiotic-rich foods like low-fat yoghurt and kefir, integrated seamlessly into your daily routine.
5. Harmonise with Regular Eating Patterns: Sync your meals with the rhythm of your body. Your digestive system operates optimally by following a consistent eating schedule, avoiding unnecessary strain. Breakfast, lunch, dinner, and snacks regularly create a harmonious environment, reducing the likelihood of bloating and indigestion. Aim for meals every 3 to 4 hours to facilitate effective digestion.
6. Hydration: Hydration isn’t solely about quenching your thirst; it’s a key player in digestive well-being. Adequate water intake facilitates fibre movement through your colon, culminating in softer stools that pass quickly. Sip water throughout the day to maintain a well-hydrated digestive system.

Physical Activity

Physical activity emerges as a stalwart ally when it comes to maintaining a healthy weight. Studies have shown that those who embrace an active lifestyle are more likely to keep their weight stable, whereas a sedentary existence often paves the way for incremental weight gain. However, the amount of activity required to prevent weight gain remains a subject of ongoing debate. Recent research suggests that the recommended two-and-a-half hours of weekly training must be revised.

Intriguingly, the Women’s Health Study followed 34,000 middle-aged women over 13 years to discern the optimal activity level for weight maintenance. The findings underscored that women in the normal weight range required an hour of moderate-to-vigorous physical activity daily to retain their weight within a 2-3kg range.

Vigorous Activity vs. Walking

Unveiling the nuances of activity intensity, the research emphasizes the effectiveness of vigorous activities over leisurely walks in weight control. The Nurses’ Health Study II, tracking over 18,000 women for 16 years, revealed that incorporating 30 minutes of additional daily physical activity led to less weight gain. Vigorous pursuits like bicycling and brisk walking emerged as practical strategies, while slow walking failed to yield comparable results.

Activity and Weight Loss

While exercise undoubtedly contributes to weight loss, it synergizes most effectively with a reduced-calorie diet. Studies indicate that in the absence of calorie moderation, extended periods of exercise or high-intensity workouts become essential for weight loss success. Research on overweight, inactive adults showcased that high-intensity exercise resulted in abdominal fat loss, whereas low- and medium-intensity routines elicited no significant change.

A parallel trial on post-menopausal women engaging in moderate-to-vigorous aerobic activity for 45 minutes five days a week unveiled notable reductions in body weight, body fat, and abdominal fat over a year.

How Activity Fights Obesity?

The mechanisms by which physical activity counters obesity are multifaceted:

1. Enhanced Energy Expenditure: Physical activity increases overall energy expenditure, enabling weight maintenance or loss, as long as calorie intake isn’t escalated to counteract the extra burned calories.
2. Fat Reduction: Activity targets total body and waistline fat, retarding the onset of abdominal obesity.
3. Muscle Power: Muscle-strengthening endeavours, from weight lifting to push-ups, augment muscle mass, elevating resting energy expenditure and supporting weight management.
4. Mood Uplift: Physical activity alleviates depression and anxiety, fostering commitment to exercise regimens over time.

The Optimal Daily Activity Quota

Aspiring to do at least an hour of activity daily for effective weight control proves pivotal. While 30 minutes of moderate exercise on most days can lower the risk of chronic disease, a more active lifestyle is essential to counterbalance sedentary habits and societal influences that fuel overeating.

Recognise that fostering an active lifestyle is not solely an individual endeavour as our environment significantly influences our activity levels. Factors such as accessible parks, sidewalks, and bike paths play a role.

Common Digestive Disorders

From time to time, many of us encounter stomach issues that range from minor discomfort to more severe disturbances. These concerns stem from our eating habits, stress, or digestive disorders. Symptoms like cramps, vomiting, and changes in stool consistency can signal something amiss in our gastrointestinal (GI) tract. This complex system involves various organs working together to nourish our bodies and eliminate waste.

Digestive disorders manifest when the intricate balance of the digestive system falters. Experts categorize these disorders into two main types: organic and functional GI disorders. 

Organic GI Disorders: These disorders arise from structural abnormalities in the digestive system that impede proper function.

Functional GI Disorders: Despite appearing structurally normal, the GI tract doesn’t perform as it should in these disorders.

Common Digestive Disorders and Their Symptoms

1. Irritable Bowel Syndrome (IBS): A prevailing symptom of IBS is abdominal pain, which can occur before or after bowel movements. Diarrhoea, constipation, or a combination of both are also characteristics. Other signs include bloating, white mucus in stools, and a feeling of incomplete bowel movements. Traumatic life events, mental health conditions, infections, or small intestinal bacterial overgrowth (SIBO) can also contribute to IBS.
2. Small Intestinal Bacterial Overgrowth (SIBO): SIBO arises when bacteria from the large intestine invade the small intestine. Symptoms include bloating, diarrhoea, and constipation. Treatment often involves antibiotics and medications to address digestion and underlying causes.

When Should You Consult a Doctor?

For those experiencing the disorders above, knowing when to contact a doctor is vital.

1. IBS: Seek medical advice if severe abdominal pain, cramps, or other IBS symptoms disrupt daily life or worsen suddenly.
2. SIBO: If you’re facing SIBO symptoms for the first time, immediately contact a doctor. Consultation is crucial if you have a prior diagnosis and your symptoms worsen, or treatment proves ineffective.

Navigating Digestive Wellness

Understanding digestive disorders empowers you to identify symptoms, seek proper treatment, and enhance your overall well-being. Whether you’re dealing with the everyday challenges of IBS or facing rarer conditions, such as Hirschsprung’s disease or achalasia, timely medical intervention can make a difference. Remember, your digestive health is a fundamental aspect of your overall health, and seeking professional guidance ensures you can face any challenges that arise on this journey to well-being.

At MHC, we recognize the power of early diagnosis, enabling timely intervention and improving disease management outcomes. From the initial consultation to follow-ups, our program will continue to help patients control and manage weight, a great way to avoid colorectal cancer.

You may book an appointment in Amara Clinic or contact our Corporate HQ for questions and enquiries about personal and corporate healthcare programmes, including Executive Health Screenings, GP services, or weight management programmes. Staying healthy and active helps promote a healthy colon. Please chat with us through Whatsapp for more information.

References:

• https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/physical-activity-and-obesity/
• https://www.healthxchange.sg/digestive-system/stomach/how-to-protect-improve-digestive-system-gut-health
• World Health Organization. Global recommendations on physical activity for health; 2011. Accessed January 30, 2012.

Colorectal Cancer Early Detection Strategies in Singapore

Colorectal cancer is a formidable adversary, but with early detection and proactive measures, it’s a battle that you can win. This comprehensive guide aims to empower Singaporeans with knowledge about colorectal cancer, the importance of screening and the actionable steps they can take to safeguard their colorectal health.

Understanding Screening: A Vital Step in Colorectal Cancer Prevention

Screening involves looking for cancer before any symptoms appear. Detecting cancer early dramatically improve treatment success rates. Doctor would usually recommend screenings based on age, family history, and lifestyle. Remember that a screening test doesn’t imply a cancer diagnosis; it’s a preventative measure.

Colorectal Cancer: The Basics

Colorectal cancer originates in the colon or rectum’s tissues, part of the digestive system. The digestive system breaks down nutrients and eliminates waste from the body. Colorectal cancer ranks the third leading cause of cancer-related deaths globally. While various factors influence the risk of developing colorectal cancer, early detection and prevention are critical.

Why Early Detection Matters

Early detection offers a significant advantage when it comes to colorectal cancer. It’s essential to emphasise that the earlier cancer is found, the more treatable it is. This is why regular screenings are recommended, even if you feel healthy.

Types of Colorectal Cancer Screening Tests

There are various screening tests available to detect colorectal cancer. These include:

1. Faecal Occult Blood Test (FOBT): This test checks the stool for traces of blood not visible to the naked eye.

         Two types are used:

1. • Guaiac FOBT – which detects colour changes on a particular card.
   • Immunochemical FOBT (FIT) – which uses antibodies to detect blood. If blood is found, further testing is recommended.
2. Sigmoidoscopy: A procedure involving a thin, flexible tube inserted into the rectum and lower colon to examine for polyps and cancer. It’s a vital tool for early detection.
3. Colonoscopy: Similar to sigmoidoscopy, but covers the entire colon. It’s performed using a longer tube and offers the advantage of removing polyps and taking tissue samples for examination.
4. Virtual Colonoscopy: This involves creating detailed images of the colon using X-rays. While it’s less invasive, any abnormalities require further testing.
5. DNA Stool Test: This test analyses stool DNA for genetic changes that could indicate colorectal cancer.

Understanding the Risks of Screening

While screenings are crucial, it’s essential to be aware of the potential risks:

• False-Negative Test Results: Sometimes, even with cancer, the test might show normal results, leading to delayed diagnosis and treatment.
• False-Positive Test Results: The test might suggest cancer when none exists, causing undue anxiety and necessitating further testing.
• Complications from Screening Tests: Procedures like colonoscopy and sigmoidoscopy carry minimal risk, including tearing of the colon lining and bleeding.

The Power of Colorectal Cancer Screening

Colorectal cancer screenings save lives. Detecting polyps and cancer at an early stage can prevent the progression of the disease and increase the chances of successful treatment.

When to Get Screened

According to local guidelines, commencing at age 50, screening is recommended for individuals without risk factors. Screening should be initiated for those with heightened risk before turning 50, depending on the specific risk factor(s) at play.

Choosing the Right Screening Test

Different screening tests have pros and cons; your personal preferences, medical history, and risk factors should influence your choice. Options include stool tests (FOBT, FIT, and FIT-DNA), sigmoidoscopy, colonoscopy and virtual colonoscopy.

In the ongoing battle against colorectal cancer, new research has unveiled compelling evidence highlighting the impact of diet and lifestyle choices on cancer risk. A recent report, a breakthrough in the field, has provided insights into the role of wholegrains in reducing the risk of colorectal cancer. This article delves into these findings and sheds light on other factors influencing your risk of developing this disease.

The Wholegrain Advantage

Research has unearthed a critical link between wholegrain consumption and colorectal cancer risk reduction for the first time. The report revealed that consuming 3 servings, totalling 90g, of wholegrains daily, such as brown rice or wholemeal bread, can lead to a 17% reduction in the risk of colorectal cancer. But how do wholegrains achieve this?

One mechanism is accelerating the transit time of potential carcinogens through the bowel, reducing the duration they come into contact with the cells lining the bowel. This underscores the preventive potential of wholegrains and highlights the importance of dietary choices in shaping cancer risk.

Unveiling Risk Factors

The report doesn’t just stop at the positive aspects of prevention. It also reinforces certain well-known risk factors that increase the likelihood of colorectal cancer:

• Processed Meat Consumption: Indulging in processed meats like bacon or salami heightens the risk of colorectal cancer.
• Excessive Red Meat Intake: Consuming more than 500g of cooked red meat per week, such as beef or pork, increases risk.
• Alcohol Consumption: Consuming two or more alcoholic drinks daily, equivalent to two glasses of wine or two-spirit measures, elevates the risk.
• Weight Management: Being overweight or obese correlates with colorectal cancer risk.

On the flip side, the report further substantiated the positive effects of physical activity. Regular physical activity, like cycling to work or using the stairs, has been found to decrease the risk of colon cancer. This serves as a reminder of the multifaceted impact of our lifestyle choices on our overall health.

Taking Practical Steps Towards Prevention for Singaporeans

1. Embrace Positive Dietary Changes: Reduce red and processed meat consumption research indicates that consuming red and processed meat can elevate your chances of developing bowel cancer.

These categories encompass beef, lamb, pork, goat, sausages, bacon, cured meats and reformed meat products. If your daily intake exceeds 90g of red or processed meat, aim to cut it down to no more than 70g. To put this into perspective, one back bacon rasher equals around 25g; a single sausage is about 60g, a medium pork chop weighs approximately 120g and a medium steak clocks in at about 115g.

1. Increase Dietary Fibre: Intake fibre plays a vital role in a healthy diet by supporting digestion, preventing constipation and reducing the risk of bowel cancer. Add wholegrain cereals, wholewheat pasta, oats, beans, chickpeas and lentils to boost your fibre intake.
2. For adults, daily consumption of at least 30g is recommended. For example, two slices of wholemeal toasted bread provide 5.6g of fibre, while a baked jacket potato with the skin on delivers 4.7g.
3. Stay Hydrated: Aim to consume 6-8 glasses of fluids each day. Water, low-fat milk, sugar-free drinks, tea and coffee count toward hydration. While fruit juices and smoothies also contribute to fluid intake, limit their consumption to a combined total of 150ml per day, considering their sugar content. Swap out sugary soft drinks for diet, sugar-free or no added sugar alternatives to effortlessly reduce sugar intake.
4. Maintain a Healthy Body Weight: Carrying excess weight, especially around the waist, increases your susceptibility to bowel cancer. It is estimated that 11 out of 100 bowel cancer cases are linked to unhealthy body weight in the UK. Checking your Body Mass Index (BMI) provides a simple gauge of your weight’s appropriateness for your height.
5. Embrace Physical Activity: Engaging in regular physical activity diminishes your risk of developing bowel cancer. An active lifestyle aids in maintaining a healthy weight and promoting overall well-being.

Adults over 19 should strive for daily activity, with at least 150 minutes of moderate-intensity exercise spread across a week. This can translate to 30 minutes of brisk walking five times a week, which can be extended to 60 minutes as fitness improves. If you’re new to physical activity, begin with 10 minutes and gradually increase. The guidelines also advise including strength training twice a week. Apart from being physically active, especially for those over 65, minimising prolonged periods of sedentary behaviour is essential.

1. Limit Alcohol Consumption: Alcohol consumption is linked to various cancers, including bowel cancer. Roughly 6 out of 100 bowel cancer cases in the UK are associated with alcohol intake. To cut down on alcohol, incorporating several drink-free days into your week is a practical approach.
2. Quit Smoking:  Around 7% of bowel cancer cases in the UK are attributed to smoking. The risk escalates with the number of cigarettes smoked daily. Smokers are more likely to develop non-cancerous growths (polyps) in the bowel, which could turn cancerous if left untreated.

Empowering Yourself for a Healthier Future

Colorectal cancer’s prevalence is a concern, but we possess strong evidence that underscores the power of lifestyle changes. By embracing a diet rich in whole grains, moderating red and processed meat consumption, limiting alcohol intake and staying active, you take proactive steps towards fortifying your body’s defences against colorectal cancer.

It’s not about drastic shifts but gradual, sustainable changes that accumulate over time. With this knowledge, you can make choices supporting your colorectal health, creating a foundation for a brighter, cancer-free future.

At MHC, we recognize the power of early diagnosis, enabling timely intervention and improving disease management outcomes. From the initial consultation to follow-ups, our program will continue to help patients control and manage weight, which is a great way to avoid colorectal cancer.

You may book an appointment in Amara Clinic or contact our Corporate HQ for questions and enquiries about personal and corporate healthcare programmes, including Executive Health Screenings, GP Services, or Weight management programmes. Staying healthy and active helps promote a healthy colon.

Resources:

• https://www.wcrf.org/positive-steps-to-decrease-colorectal-cancer-risk/
• https://pubmed.ncbi.nlm.nih.gov/35283438/
• https://www.aicr.org/resources/blog/new-colorectal-cancer-report-your-faqs-answered/
• https://ukhsa.blog.gov.uk/2019/04/01/seven-ways-to-reduce-your-risk-of-bowel-cancer/

Understanding Hypotension: Tips for Health-Conscious Singaporeans

Low blood pressure, also known as hypotension, is a condition that occurs when the blood pressure drops below the normal range. While some individuals with low blood pressure may not experience noticeable symptoms, others may suffer from dizziness and fainting. In severe cases, hypotension can even be life-threatening. Health-conscious Singaporeans must know the causes, symptoms, potential risks of low blood pressure and when to consult a healthcare professional for proper evaluation and personalised advice.

What is Hypotension?

Low blood pressure, also known as hypotension, is a condition that occurs when the blood pressure drops below the ‘normal’ range – or rather, below the normal expected for an individual in a given environment. Whilst systolic blood pressure (SBP) less than 90mmHg and diastolic blood pressure (DBP) less than 60 is the commonly recognised cut-off, there is no single universally accepted numerical cut-off. In individuals with marginally lower pressures than the commonly recognised range but have no evident worrying symptoms or pathological conditions identified – it may just be the norm for them. However, if the BP is significantly reduced and blood flow to the vital organs are compromised, symptoms such as dizziness/fainting may manifest. In such situations, this need to be addressed promptly as it can results in serious consequences, even fatality.

Causes and Symptoms:

Low blood pressure can be triggered by various factors. Determining the root cause is essential for proper management. Common causes include:

1. Dehydration/Blood loss – this leads to volume loss resulting drop in pressure.
2. Pregnancy: Blood vessels expand as a natural process, leading to pressure drop. This is more typical in the 1-2^nd
3. Certain medications – Certain medications such as those for managing hypertension naturally leads to drop in pressure.
4. Medical conditions such as Heart/valve disease, Parkinson’s disease, Endocrinopathies.
5. Severe infections – Situations like this can affect the body to lose its ability to regulate the mechanisms to maintain proper blood pressure. The process is usually complex and may be associated with multi-organ failure.
6. Severe allergic reactions – this is a extreme situation where the chemicals/mediators released in response to an allergen lead to a chain of effects resulting in cardiovascular collapse.

Symptoms of hypotension:

• Dizziness
• Light headedness,
• Fainting when moving from a lying or sitting position to standing.
• Confusion
• In severe cases, a sudden and persistent drop in blood pressure can lead to a life-threatening condition known as “shock,” which requires immediate medical attention to prevent organ damage and potential fatality.

Types of Hypotension:

Different types of low blood pressure are observed in individuals, each with its specific triggers and demographics affected. Broad categories include:

1. Orthostatic Hypotension (Postural Hypotension):

This type of hypotension occurs when there is a sudden decline in blood pressure upon standing from a sitting or lying position. It is common in older adults and can be caused by dehydration, long-term bed rest, pregnancy, certain medical conditions, and specific medications.

1. Postprandial Hypotension:

Postprandial hypotension is characterized by a drop in blood pressure 1 to 2 hours after eating. It primarily affects elders, especially those with high blood pressure or autonomic nervous system diseases like Parkinson’s. Lifestyle modifications such as eating small, low-carbohydrate meals, staying hydrated, and avoiding alcohol can help manage this condition.

1. Neurally Mediated Hypotension (Vasovagal syncope):

Young adults and children are more susceptible to neurally mediated hypotension triggered by standing for extended periods. It results from miscommunication between the heart and the brain.

Diagnosis and Treatment of Hypotension:

Diagnosing low blood pressure (hypotension) involves a thorough physical examination and medical history assessment by a healthcare provider. Measuring blood pressure is a fundamental part of this process.

Additionally, specific tests may be conducted to identify the underlying cause of low blood pressure:

1. Blood Tests: These tests help diagnose conditions that can lead to low blood pressure, such as hypoglycemia (low blood sugar), hyperglycemia (high blood sugar or diabetes), or anaemia (low red blood cell count).
2. Electrocardiogram (ECG or EKG): This quick and painless test assesses the heart’s electrical activity. It can help diagnose current or previous heart attacks.
3. Tilt Table Test: The test evaluates how the body reacts to positional changes. During the test, the patient lies on a table that tilts, simulating the transition from a horizontal to a standing position. Heart rate and blood pressure are closely monitored during the procedure.

Treatment of low blood pressure depends on its underlying cause. If low blood pressure is causing symptoms, addressing the root issue becomes essential. For instance, if certain medications contribute to low blood pressure, the healthcare provider might recommend adjusting the dosage or switching to alternative medicine. It’s crucial to consult the healthcare provider before modifying or discontinuing any medication.

In cases where the cause of clinically significant low blood pressure is unclear, or no specific treatment exists, the primary goal is to raise blood pressure and alleviate symptoms.

Here are some approaches to achieve this:

• Increase Salt Intake: For individuals with low blood pressure, consuming slightly higher amounts of salt can be beneficial. However, seeking advice from a healthcare provider is essential, as excessive sodium intake can lead to heart failure, especially in older adults.
• Stay Hydrated: Drinking fluids, especially water, can help increase blood volume and prevent dehydration, essential in managing hypotension.
• Wear Compression Stockings: These elastic stockings, also known as support stockings, aid in improving blood flow from the legs to the heart. They can be particularly helpful in alleviating pain and swelling associated with varicose veins.
• Medications: Specific medications may be prescribed in cases of orthostatic hypotension (low blood pressure upon standing). For example, fludrocortisone can boost blood volume, and midodrine may reduce the ability of blood vessels to expand, thereby raising blood pressure.

Preventive Measures for Health-Conscious Singaporeans:

For individuals aiming to maintain optimal health and manage hypotension effectively, the following tips can prove beneficial:

1. Stay Hydrated: Drinking adequate water throughout the day helps prevent dehydration, a common cause of low blood pressure.
2. Limit Alcohol Intake: Excessive alcohol consumption can cause a drop in blood pressure, so moderate drinking is advisable.
3. Gradual Postural Changes: When transitioning from lying to sitting or standing, do so slowly to allow the body time to adjust to the changes in blood pressure.
4. Regular Exercise: Physical activity improves cardiovascular health and can help regulate blood pressure levels.
5. Balanced Diet: Opt for a diet rich in vegetables, fruits, and whole grains, while restricting salt and processed foods to maintain healthy blood pressure.

What you can do?

Understanding hypotension is vital for health-conscious individuals in Singapore. While low blood pressure may not always present noticeable symptoms, its potential risks should not be underestimated. By staying hydrated, adopting a balanced diet, and making lifestyle adjustments, it’s possible to manage and prevent the adverse effects of low blood pressure.

If you experience persistent symptoms, it’s crucial to consult a healthcare professional for proper evaluation and personalized advice. Taking proactive steps towards maintaining healthy blood pressure levels will contribute to overall well-being and a better quality of life.

Take charge of your employees’ or your health with MHC’s comprehensive Health Screening packages. Early screening and detection can prevent serious conditions from developing later in life. Our customizable test packages include essential measurements like height, weight, BMI, blood pressure, cholesterol, and diabetes screening.

Whether you need standard packages or tailored solutions for your company’s requirements, MHC has you covered. Our facilities are conveniently located across Singapore, ensuring your employees receive the best care possible.

Invest in your health today! Contact us to discuss your corporate health screening needs. Together, let’s prioritize a healthier and happier workforce.