Hypertension, or high blood pressure, is a long-term condition where the force of blood against the artery walls remains consistently elevated. Often referred to as the “silent killer,” it typically presents few or no symptoms, making regular blood pressure checks crucial. Hypertension is diagnosed when blood pressure consistently measures 140/90mmHg or higher, confirmed through readings taken on two or three separate occasions. However, blood pressure levels between 130-139mmHg systolic and 85-89mmHg diastolic are already considered “at-risk.” Individuals in this range should closely monitor their readings and adopt lifestyle changes to help reduce 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. Despite these significant risks, many Malaysians remain oblivious to their hypertensive status, often due to the condition’s asymptomatic nature in its early stages.
Dr Jolene See Su Chen, Consultant General Physician (Internal Medicine) at the Wellness Centre, Sunway Medical Centre in Sunway City, brings critical insights into the myths and facts surrounding hypertension. She emphasises the importance of regular health screenings and maintaining a healthy lifestyle, stressing that hypertension, once developed, is a chronic condition that requires ongoing management and vigilance for a lifetime. Her expertise sheds light on the growing concern of hypertension, particularly among younger populations.
Dr Jolene notes a worrying trend: “Hypertension in Malaysia has seen a steady increase, particularly among those under 40, with some patients even in their twenties.” She explains that 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,” warns Dr Jolene.
The Subtle Symptoms and Serious Complications
Hypertension is a disease that is often asymptomatic, which is why regular screenings are important. When subjects complain of symptoms, the disease may have already existed for quite a while. Symptoms may include headache, dizziness, breathlessness, pain in the chest and epistaxis. These include paralysis, heart attack, heart failure, arrhythmias, kidney failure, and vision loss among others.
Hence, Dr Jolene emphasises, “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,” says Dr Jolene.
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,” says Dr Jolene. She adds some general guidelines for maintaining a healthy weight, which are:
- 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.
Dr. Jolene emphasises the importance of following prescribed treatments for hypertension, urging newly diagnosed patients to take the condition seriously, make necessary lifestyle adjustments, and strictly follow their doctor’s advice without changing their medication doses on their own. She also debunks a common misconception that long-term use of hypertension medication can harm the kidneys and cause kidney failure. Dr. Jolene warns that this belief is dangerous, as all medications are scientifically tested and prescribed in safe doses under medical supervision. In fact, untreated hypertension poses a far greater risk, as it can damage the blood vessels that supply the kidneys, leading to kidney failure and harm other vital organs at a much faster and more severe rate.
Living well with Hypertension
Prevention starts with awareness, knowledge, and actions. The risk factors that are known, along with making wise choices for a healthy diet, a reduction in sodium intake, and balancing life on a routine exercise schedule, can only account for preventing hypertension from affecting an individual. The support of family and friends also matters a lot because sometimes family and friends may encourage them to maintain good practices and remind them to take medication and visit a doctor for blood pressure checkups according to the schedule. This is possible through knowing the risks of hypertension and taking precautionary measures to safeguard the health of the future generations from this looming health danger.
The Sunway Medical Centre is at Sunway City, which is a 28 Center of Excellence quaternary private hospital established in 1999 with a multidisciplinary medical team offering personalized treatment with a dedicated holistic care approach. This year, SMC is celebrating its 25th anniversary and is accredited by Joint Commission International, the Australian Council on Healthcare Standards, and the Malaysian Society for Quality in Health. This has further been listed among the top 250 hospitals in Newsweek’s 2024 World’s Best Hospitals rankings.
All the information and images are provided by Sunway Medical Centre.
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