Hypertension is a growing threat in Malaysia – What you can do about it
by Dr Jolene See Su Chen, Consultant General Physician (Internal Medicine), Wellness Centre, Sunway Medical Centre
Hypertension: the “silent” killer among us
Hypertension, or high blood pressure, is a chronic condition where the blood force against artery walls is consistently high. Known as the “silent killer,” it often has few or no symptoms, making regular monitoring essential. Hypertension is defined as persistent elevation of blood pressure at or above 140/90mmHg, confirmed by measurements taken on at least two to three separate occasions. However, blood pressure readings in the range of 130-139mmHg systolic and 85-89mmHg diastolic are already considered “at-risk”. People with blood pressure within this range should monitor their blood pressure closely and make lifestyle changes to help lower their blood pressure.
According to the National Health and Morbidity Survey 2023, hypertension affects 29.2% or nearly one in three adults in Malaysia. Of this figure, 11.9% do not actually know that they have hypertension and alarmingly, the highest proportion of those who are unaware falls within the age of 18-39, indicating a rising concern in younger populations.[1] Despite these significant risks, many Malaysians remain oblivious to their hypertensive status, often due to the condition’s asymptomatic nature in its early stages.
A worrying trend among younger groups
The importance of regular health screenings and maintaining a healthy lifestyle cannot be stressed enough because hypertension, once developed, is a chronic condition that requires ongoing management and vigilance for a lifetime.
Hypertension in Malaysia has seen a steady increase, particularly among those under 40, with some patients even in their twenties. This shift is due to a complex interplay of genetic predisposition, lifestyle factors, and dietary habits. Dr Jolene also highlights a prevalent myth that hypertension is only a concern for the elderly. This misconception is dangerous. Many younger people believe they are not at risk, leading to neglect and late diagnosis.
Subtle symptoms, serious complications
There is often no sign or symptom in hypertension, making regular screenings essential. When symptoms do occur, hypertension may have already been present for some time. These symptoms may include headaches, dizziness, shortness of breath, chest pain and nosebleeds[2]. If left untreated, hypertension can lead to severe and potentially life-threatening complications, including heart attack, heart failure, irregular heart rhythm, stroke, kidney failure, and vision loss[3].
Hence, people should minimally get their blood pressure checked at least once a year as part of their annual health screening. Blood pressure should also be checked during clinic encounters when visiting the doctor for other health concerns. Those with a family history of hypertension or heart disease should monitor their blood pressure regularly at home. Early detection is key to managing the condition effectively.
Lifestyle and dietary habits: culprits behind the numbers
Many Malaysians consume diets high in salt and fat, and low in essential nutrients. Combined with a lack of physical activity and high-stress work environments, it’s a perfect storm for developing high blood pressure.
People are advised to control their daily sodium intake, keeping it below 2,000mg a day, which is equivalent to approximately 1 teaspoonful a day. We can also learn more about Dietary Approaches to Stop Hypertension (DASH), which is designed to help prevent or treat hypertension and may also help lower LDL cholesterol linked to heart disease. The DASH diet focuses on increasing intake of vegetables, fruits, whole grains, and lean proteins (from lean meat, poultry or fish). It is also important to choose foods that are low in saturated and trans fat, which are commonly found in processed food.
Managing hypertension: lifestyle changes and medication
Managing and preventing hypertension involves proactive steps. Eating a balanced diet rich in fruits and vegetables, reducing salt and alcohol intake, not smoking, keeping active with regular exercises and maintaining a healthy weight are key preventive measures.
There are also a few general guidelines for maintaining a healthy weight, which are[4]:
. Body Mass Index (BMI): Aim for a BMI between 18.5 and 22.9, based on the Malaysia CPG Management of Obesity 2023
. Waist Circumference: Men should aim for a waist circumference of less than 90cm and women less than 80cm, based on the Malaysia CPG Management of Obesity 2023
. Weight Loss: Even a modest weight loss of 5-10% of your current weight can significantly improve blood pressure and overall health.
The importance of complying with prescribed treatments for hypertension lies in advising newly diagnosed patients to take their condition seriously, make necessary lifestyle changes, and follow their doctor’s advice without independently adjusting medication dosages.
Be aware of this common myth that taking long-term medication might harm their kidneys and lead to kidney failure. This mindset is “dangerous”, as all medications are scientifically tested and prescribed at safe dosages under the supervision of the patients’ doctor. In contrast, untreated hypertension can severely damage blood vessels supplying the kidneys, leading to kidney failure and damaging other vital organs, much more quickly and severely.
Regaining your quality of life
Prevention begins with awareness, knowledge, and action. Understanding the risks and making informed choices, such as adopting a healthy diet, reducing sodium intake, and maintaining a balanced lifestyle with regular exercises are key steps in preventing hypertension. Family and friends play a vital role by supporting those with hypertension, reminding them to take their medication, monitor blood pressure regularly, and encourage healthy habits. By understanding the dangers of hypertension and taking proactive steps, we can combat this growing health threat and safeguard the well-being of future generations.
[1]https://iku.nih.gov.my/images/nhms2023/key-findings-nhms-2023.pdf
[2]https://www.verywellhealth.com/symptoms-of-hypertension-1763965
[3]https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868
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