Hypertension – Shining The Spotlight On A Silent Killer

Only five out of ten people in Malaysia are aware of their hypertensive status.

Hypertension is a systemic condition that can be defined as systolic blood pressure (SBP) of 140 mm Hg or more, or diastolic blood pressure (DBP) of 90 mm Hg or more.

Pit simply, hypertension is a condition whereby blood vessels have unusually raised pressure persistently.

It is estimated that 1.13 billion people throughout the world are currently suffering from hypertension, of which two-third are living in low-income or middle-income countries.

To combat hypertension. the World Health Organization (WHO) has created a campaign for action for non-communicable diseases, consisting of nine global voluntary targets.

Among these targets, Target Six aims to reduce the prevalence of hypertension by 25 per cent by 2025 at the soonest.

In Malaysia, one in three people over the age of 18 are at risk of developing hypertension, and one in four men and one in five women have high blood pressure.

According to the National Health and Morbidity Survey (NHMS), done by the Ministry of Health (MOH) in 2019, hypertension is one of three major risk factors leading to heart disease, along with diabetes mellitus and high cholesterol.

Approximately 1.7 million Malaysians currently live with all three risk factors, which highlights the need for awareness and prompt treatment of hypertension among Malaysians.

Hypertension, through its complications, has the dubious reputation of being the leading risk factor that directly contributes to the death of 1.5 million Malaysians annually.

Generally, risk factors can be classified according to modifiable and non-modifiable risk factors.

Non-modifiable risk factors include a family history of hypertension, gender and ethnicity.

Modifiable risk factors such as smoking, obesity, lack of physical activity, and consumption of alcohol, contribute to the majority of hypertensive patients in Malaysia.

Why is hypertension known as a silent killer? Hypertension almost usually has little to no symptoms, putting Malaysians at risk of not knowing whether they even have the condition or not.

It is often too late when people are diagnosed with hypertension as they have been hypertensive for a long time.

Hypertension mainly affects three major organs, namely the kidneys, the heart, and the brain. Failure of these organs can lead to death.

In renal damage, chronic renal failure that precedes end stage failure arises due to increased pressure on kidneys to produce ultrafiltrate, causing damage to nephrons and results in failure of the kidneys to maintain its function.

In cardiovascular disease, increased arterial blood pressure results in left ventricular hypertrophy (thickening of the left ventricle of the heart) causes a myriad of heart related diseases including myocardial infarction, heart failure and arrhythmias.

In the brain, stroke or cerebrovascular accident (CVA) is the gravest consequence of hypertension. Hypertension also has had adverse effects on vision and sexual function, especially in males, as high blood pressure damages artery walls, causing them to harden and narrow thus leading to reduced blood flow to the penis.

The statistics and the negative effects caused by hypertension should concern Malaysians from all walks of life. Malaysia, as of 2020, has carried out many different initiatives through various activities across all levels of the society.

Commonly, screening of hypertensive patients at Malaysian hospitals, community health clinics and rural health clinics can usually identify hypertensive patients in the population.

Community-based screening and self-arranged health checks also assist in the recognition of patients suffering from hypertension, that would have otherwise gone undiagnosed and untreated leading to increased mortality rates.

The involvement of Malaysians in general plays an important part in bringing down statistics involving hypertension in the country.

Hypertensive patients are in fact, the most powerful inciters of change by educating and empowering their friends and family members to take control of their health and encourage them to check on their blood pressure often.

Medical students and organisations such as Malaysian Medics International (MMI) can be the voice of change on the impact of hypertension on Malaysians, by framing policies and advocating for further screening procedures in our country.

Ongoing campaigns such as Kempen Sayangi Jantung Anda, kicked off by MOH to combat heart disease alongside Kempen Kesedaran Darah Tinggi and Kempen Cara Hidup Sihat aim to promote awareness on the dangers of heart disease and hypertension.

Community leaders also play an important role in spreading information and proactively involving local authorities in the screening of people for the risk factors of hypertensive disease by setting up local health camps often, especially in conjunction with important dates such as World Heart Day, which falls on September 29 every year.

We have seen many initiatives involving many different parties in the fight to reduce and ultimately end hypertension as a threat to Malaysian health care and the wellness of its people.

Yet, despite their ongoing efforts, many Malaysians still lack awareness regarding hypertension.

Good dietary practices such as reducing salt intake and reducing the intake of fatty and oily foods, looking at alternative ways to handle stress at workplaces and encouraging physical activity and active participation of smokers in anti-smoking campaigns and clinics would definitely bring many positive effects in the drive to end hypertension in Malaysia.

Keep hypertension at bay for a healthy day.

Written by Arravinnath Subramanium.


Man Jun Soo, Zhen Yee Chow, Siew Mooi Ching, Chun Han Tan, Kai Wei Lee, Navin Kumar Devaraj, Hani Syahida Salim, Vasudevan Ramachandran, Poh Ying Lim, Dhashani Sivaratnam, Fan Kee Hoo, Ai Theng Cheong, Yook Chin Chia; Prevalence, awareness and control of hypertension in Malaysia from 1980-2018: A systematic review and meta-analysis; Baishideng Publishing Group Inc; August 28 2020.

Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD; What is the definition of hypertension (high blood pressure); February 22 2019.

National Health and Morbidity Survey 2019, Ministry of Health Malaysia, 2019.

Ooi Wei Lim and Chen Chen Yong; The Risk Factors for Undiagnosed and Known Hypertension among Malaysians; November 4 2019.

Franz H. Messerli, Prof Bryan Williams, Prof Eberhard Ritz; Essential Hypertension; The Lancet; August 18, 2007.

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