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.

Preventing Hepatitis: A Comprehensive Guide for Health-Conscious Singaporeans

Hepatitis is a condition characterised by liver inflammation and can be caused by various factors, including viral infections, bacteria, and toxins. Acute Hepatitis is primarily driven by Hepatitis A, B, C, and E viruses, although other non-liver-specific viruses can also trigger it. As for chronic Hepatitis, the most common culprits are the Hepatitis B and Hepatitis C viruses. According to SingHealth, Hepatitis B is the leading cause of chronic viral Hepatitis in Singapore.

Hepatitis Symptoms

Hepatitis A symptoms usually develop within 15 to 50 days after exposure to the virus. They can include:

• Fatigue
• Fever
• Loss of appetite
• Nausea
• Vomiting
• Diarrhoea
• Dark urine
• Light-coloured stools
• Joint pain
• Abdominal pain
• Jaundice (yellowing of the skin and eyes)

Hepatitis B symptoms can develop anywhere from a few weeks to several months after exposure to the virus. They can be similar to the symptoms of hepatitis A, but they can also be more severe. Some people with hepatitis B may not have any symptoms at all.

Hepatitis C symptoms can develop for weeks, months, or even years. Many people with hepatitis C never develop any symptoms. When symptoms occur, they can be similar to the symptoms of hepatitis A or B.

Hepatitis D symptoms are the same as the symptoms of hepatitis B. However, hepatitis D can only occur in people infected with hepatitis B.

Hepatitis E symptoms are fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, pale stools, and jaundice.

Hepatitis Transmission

Hepatitis A is spread through the faecal-oral route which can be transmitted through stool contact with an infected person. This often happens from contaminated food or water or close personal contact, such as sexual contact or sharing needles.

Hepatitis B is spread by getting contact with infected blood or body fluids. This can happen through sharing needles, through sexual contact, from mother to child during childbirth, or through medical procedures involving using contaminated needles or equipment.

Hepatitis C is often spread through contact with infected blood. However, it is less easily transmitted than hepatitis B. At times, it is spread through sexual contact but is less common.

Hepatitis D can only occur in people already infected with hepatitis B. It is spread through the same routes as hepatitis B, including sharing needles, sexual contact, and from mother to child during childbirth.

Preventing Hepatitis

Hepatitis A Prevention

• Get vaccinated against hepatitis A.
• Practice good hygiene, including regular handwashing with soap and water.
• Avoid consuming contaminated food or water.
• Practice safe and protected sex and avoid sharing personal items like toothbrushes and razors.

Hepatitis B Prevention

• Get vaccinated against hepatitis B.
• Use barrier methods (condoms) during sexual activity.
• Avoid sharing needles or personal items that may come into contact with blood or body fluids.
• If pregnant, ensure prenatal screening and take appropriate measures to prevent transmission to the baby.

Hepatitis C Prevention

There is no vaccine for hepatitis C, so focus on prevention measures for hepatitis B and safe sex practices to reduce transmission risks.

Hepatitis D Prevention

As hepatitis D can only occur in individuals already infected with hepatitis B, preventing hepatitis B transmission is the primary preventive measure.

Hepatitis E Prevention

Avoid consuming contaminated water and practice good hygiene when handling food.

Diagnosing Hepatitis

Some diagnostic tests can detect Hepatitis. The type of test used will depend on the type of Hepatitis that is suspected:

Hepatitis A

The most common test for hepatitis A is an antibody test. This test measures the antibodies to the Hepatitis A virus in your blood. Antibodies are proteins your body produces as a response to an infection. If you have antibodies to hepatitis A, you have been infected with the virus at some point.

Hepatitis B

Many different tests can be used to diagnose hepatitis B. These tests include:

• Hepatitis B surface antigen (HBsAg): This test measures the levels of HBsAg in the blood. HBsAg is a protein that is produced by the hepatitis B virus. If you have HBsAg in your blood, you are currently infected with the virus.
• Hepatitis B core antibody (HBcAb): This test measures the levels of HBcAb in the blood. HBcAb is an antibody that the body produces in response to the hepatitis B core protein. If you have HBcAb in your blood, you have been infected with the virus at some point.
• Hepatitis B e antigen (HBeAg): This test measures the levels of HBeAg in the blood. HBeAg is a protein that is produced by the hepatitis B virus. If you have HBeAg in your blood, it means that you are currently infected with the virus and that the virus is actively replicating.
• Hepatitis B DNA: This test measures the levels of hepatitis B DNA in the blood. Hepatitis B DNA is the genetic material of the hepatitis B virus. If you have hepatitis B DNA in your blood, you are currently infected with the virus.

Hepatitis C

The most common test for hepatitis C is an antibody test. This test measures the antibodies to the hepatitis C virus. Antibodies are proteins your body produces as a response to an infection. If you have antibodies to hepatitis C, you have been infected with the virus at some point.

Hepatitis D

The only way to diagnose hepatitis D is to test for both hepatitis B and hepatitis D. If you have hepatitis B, you can be tested for hepatitis D by measuring the levels of hepatitis D antigen (HDAg) in the blood. HDAg is a protein that is produced by the hepatitis D virus. If you have HDAg in your blood, it means that you are currently infected with both hepatitis B and hepatitis D.

Hepatitis E

The most common test for hepatitis E is an antibody test. This test measures the antibodies to the hepatitis E virus in the blood. Antibodies are proteins your body produces as a response to an infection. If you have antibodies to hepatitis E, you have been infected with the virus at some point.

Medical Tests for Hepatitis

Liver Function Tests

• These tests measure liver enzymes and proteins in the blood to assess liver health and function.

Hepatitis Serology Tests

• Serology tests detect antibodies specific to each hepatitis virus and help diagnose the type of hepatitis infection.

Liver Biopsy

• A liver biopsy involves removing a small tissue sample from the liver for examination under a microscope to assess liver damage and inflammation.

Vaccinations for Hepatitis

Hepatitis A vaccine

Hepatitis A is a two-dose vaccine- the first dose is given as an injection, and the second dose is given 6-12 months later. The vaccine is about 95% effective in preventing hepatitis A.

Hepatitis B vaccine

The hepatitis B vaccine is a three-dose vaccine. The first dose is given as an injection, and the second and third doses are delivered 1-2 months and six months later. The vaccine is about 95% effective in preventing hepatitis B.

It is recommended to get vaccinated for all children at the following ages:

• 12 months of age
• 18 months of age
• 4-6 years of age

The hepatitis A and B vaccines are also recommendable for adults who are at increased risk of infection, such as:

• People who travel to countries where hepatitis A or B is common
• People who work in healthcare or other settings where they may be exposed to blood or body fluids
• People who have sex with multiple partners
• People who use illegal drugs

If you are concerned about your risk of hepatitis A or B, talk to your doctor. They can recommend the appropriate vaccines for you.

Hepatitis C, D, and E

There is no vaccine available for hepatitis C, D, or E. However, there are treatments available for hepatitis C. If you are concerned about your risk of hepatitis C, our General Practitioners are available for consult. We can recommend appropriate testing and treatment options for you.

Where to Get Tested for Hepatitis in Singapore

MHC offers vaccinations for Hepatitis A and B in our clinics. You may book an appointment at Amara Medical Centre or Novena clinic. Alternatively, you may also contact our clinics for the latest update on the available vaccinations. Hepatitis is preventable through vaccination, safe practices, and good hygiene. Early detection through medical testing is crucial for effective treatment and preventing severe complications. Singaporeans should take proactive measures to safeguard their health by vaccinating, practising safe behaviours, and seeking medical attention promptly. By doing so, they can significantly reduce the risk of Hepatitis and maintain a healthy and fulfilling life.

For Corporate Healthcare programme enquiries, please contact our Corporate HQ for questions and enquiries about corporate healthcare programs, including Vaccinations, Executive Health Screenings, GP Services, or Weight management programmes

Combating Fatty Liver: Healthy Habits for Health-Conscious Singaporeans

The liver is vital as your body’s primary cleaning and processing hub.

One of the liver’s essential functions is detoxification, which eliminates toxins from the bloodstream from sources like contaminated food, alcohol, and medications. Moreover, a healthy liver regulates blood sugar (glucose) levels and filters out bilirubin from the bloodstream. Bilirubin is a by-product resulting from the normal breakdown of red blood
cells.

Furthermore, the liver is responsible for processing food, extracting essential nutrients, and producing bile necessary for digesting fatty foods. It also acts as a storage centre for any surplus nutrients.

Fatty liver is a condition when there is excessive fat in your liver. It is a silent disease, meaning it often does not cause symptoms in the early stages. However, if left untreated, fatty liver disease may often lead to serious health concerns, such as liver cirrhosis and liver cancer.

Causes of Fatty Liver Disease 

Here are some causes of fatty liver disease:
– Obesity
– Overweight
– Type 2 diabetes
– High blood cholesterol
– High triglycerides
– Alcohol abuse
– Certain medications
– Some medical conditions, such as polycystic ovary syndrome (PCOS)

Symptoms of Fatty Liver Disease

In the early stages, fatty liver disease often does not cause any symptoms. However, as the disease progresses, some people may experience the following symptoms:
– Fatigue
– Weight loss
– Pain in the upper right abdomen
– Jaundice
– Nausea and vomiting
– Dark urine

Treatment for Fatty Liver Disease

Fatty liver treatment depends on the disease’s severity and underlying cause. In some cases, no treatment is necessary. However, if the condition is more advanced, treatment may include:
– Weight loss
– Exercise
– A healthy diet
– Medications to lower cholesterol and triglycerides
– Alcohol cessation

Healthy Habits for Health-Conscious Singaporeans

1. Eating a well-balanced Diet and Portion Control: A balanced diet is crucial in combating fatty liver. Aim to eat various vegetables, whole grains, fruits, lean protein, and healthy fat in your daily diet. Avoid too much consumption of sugary and processed foods, as they can contribute to fat accumulation in the liver. Additionally, practising portion control helps manage calorie intake and prevents overloading the liver with excessive fats and sugars.
2. Have regular Physical Activity: It is essential for maintaining a healthy liver. As recommended by health experts, doing at least 2 hours of moderate-intensity aerobic exercise or at least 2 hours and a half of vigorous-intensity aerobic exercise per week may be helpful. Activities like brisk walking, jogging, cycling, and swimming can significantly improve liver function and reduce the risk of fatty liver disease.
3. Limit Alcohol Consumption: Too much alcohol consumption is a leading cause of fatty liver disease. For those who consume alcohol, it is essential to do so in moderation. The recommended limits are one standard drink for women (per day) and up to two standard drinks for men (per day). Better yet, consider reducing alcohol intake or opting for non-alcoholic beverages altogether.
4. Hydration: Staying well-hydrated is vital for overall health, including liver function. Water helps flush out toxins from the body and aids digestion, preventing unnecessary stress on the liver. Aim to drink an adequate amount of water daily and reduce the intake of sugary beverages.
5. Avoid Smoking: Smoking harms your lungs and adversely affects liver health. Smoking increases oxidative stress, damaging the liver and impairing natural detoxification processes. If you are a smoker, seek support to quit and improve your liver’s overall well-being.
6. Manage Stress: Chronic stress can hurt liver health. Do stress-reducing activities such as meditation, yoga, deep breathing exercises, or time in nature. Proper stress management promotes a healthy liver and overall well-being.
7. Regular Health Check-ups: Regular health check-ups are essential for monitoring liver health and detecting potential issues early on. If you have a family history of liver disease or other risk factors, consider getting liver function tests and follow-up with your healthcare provider regularly.

Diagnosis of Fatty Liver Disease

Fatty liver disease is often diagnosed with blood tests, ultrasound, and liver biopsy.

• Blood tests: can measure liver enzymes, which are proteins released when the liver is damaged. You may have fatty liver disease if you have high levels of liver enzymes. Blood testing is the most common way to diagnose fatty liver disease, including ALT, AST, and GGT.

• • Ultrasound: is a non-invasive imaging test that can be used to view the liver. Ultrasound can measure the amount of fat in the liver and look for signs of liver damage. Ultrasound is a commonly used imaging test used to diagnose fatty liver disease.
  • Liver biopsy: a procedure where they take a small sample of liver tissue and examine it under a microscope. This procedure can be used to confirm the diagnosis of fatty liver disease and to assess the severity of the disease. It is the most accurate test for diagnosing fatty liver disease but is also the most invasive.

MHC offers weight management programmes that combine injectable or oral treatments with a complimentary workout session. The goal of managing and treating weight gain is not simply to lose weight but to improve overall health and lower the risks of other health complications. From the initial consultation to follow-ups, our program will continue to help patients control and manage weight, a great way to avoid liver disease.

To book an appointment for weight management programme, you may book at Amara Clinic or contact our clinics for your Personal Health Screenings. For Corporate Healthcare programme enquiries, please contact our Corporate HQ for questions and enquiries about corporate healthcare programs, including Executive Health Screenings, GP Services, or Weight management programmes. Staying healthy and active helps promote a healthy liver.

Staying healthy and active helps promote a healthy liver. Please chat with us through
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