Klinik Temasya
Primary Care Medicine

Hypertension - take charge of your health from home

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Hypertension or high blood pressure is a major health risk and its affecting 1 in 3 of Malaysian above the aged of 18 years old. Hypertension is a silent disease with majority of cases (as high as 61%) of Malaysian in the country are undiagnosed. Most patient are assymptomatic means they do not develop any symptoms at all. Patients may present with headache, chest pain, irregular heart beat, weakness,  blurring of vision and nosebleed when the blood pressure is severely high. Hypertension confers the greatest disease burden with high risk of mortality and morbidity in the country. Untreated or suboptimally controlled high blood pressure leads to many end-organ complications such as heart diseases, stroke and kidney failure. 

Hypertension is defined as persistent elevation of systolic BP of 140 mmHg or greater and/or diastolic BP of 90 mmHg or greater. A systolic BP of 120 to 139 and/or diastolic BP of 80 to 89 mmHg is defined as prehypertension and should be treated in certain high risk groups. There is a strong relationship between hypertension and cardiovascular health with the higher the blood pressure readings, the greater the chance of getting a heart attack, heart failure, stroke and kidney diseases. Presence of other cardiovascular risk factors such as high cholesterol, diabetes, obesity and smoking in combination further increases the risk of organ complications.

It is very important to check your blood pressure regularly, be it at your doctor visit or during your annual health screening. You can also buy a blood pressure machine and monitor your blood pressure at home. Discuss your home blood pressure target with your doctor. The target may differ according to your age, underlying chronic disease and organ complications. The target blood pressure for someone diagnosed with hypertension is generally below 140/90mmHg and 150/90 for patient above the age of 80 years old. At home the target levels are a bit lower than in the clinic. Normally, the target at home would be below 135/85mmHg. If your blood pressure is higher than predetermined target, that means your blood pressure is not optimally control. If your blood pressure is persistently above 180/90 mmHg or higher, this is termed uncontrolled severe hypertension. If you experience symtoms such as chest pain, difficulty breathing, limb or facial weakness, blurring or vision or confusion, seek medical advise immediately

Here are several tips to perform home blood pressure measurement at home:

  • Wear loose-fitting clothes that doesn't feel tight on your arm. Make sure your arm is supported and at the same level as your heart
  • Avoid measuring your blood pressure within half an hour of eating, smoking, drinking caffeinated drinks like coffee, exercise or sexual activity which can temporarily increase your bloor pressure level
  • Make sure you are relaxed and comfortable. Rest for 5 minutes before you take your reading. Legs should be uncrossed and there should be no talking, chewing or movement during the blood pressure taking process
  • Follow the instruction manual that comes with the blood pressure machine. Take two or three readings each about 1 to 2 minutes apart. If your first reading is much higher than the next, ignore it and take an extra reading. Once you have two to three readings, you can work out the average and record your measurement in your notebook or phone app. You can bring this record to show to your doctor during your visit
  • Take blood measurement at the same time each day and use the same arm

Besides monitoring your blood pressure regularly, there are also lifestyle change that can help you manage your hypertension successfully.

  • Mantain a health body mass index (BMI). For Asian, normal BMI is between 18- 24. A weight loss as little as 5% of your weight can significantly reduces your blood pressure
  • Cut down your intake of salt and processed foods. The recommended guidelines of salt intake is <100 mmol of sodium or 6g of sodium chloride a day is recommended (equivalent to <1 1/4 teaspoonfuls of salt or 3 teaspoonfuls of monosodium glutamate)
  • Moderate consumption of alcohol. For those who want to consume alcohol, the standard advice is to restrict intake to no more than 21 units for men and 14 units for women per week (1 unit equivalent to 1/2 a pint of beer or 100ml of wine or 20 ml of proof whisky)
  • Regular moderate intensity exercises, aim for 150 minutes a week such as brisk walking for 30–60 minutes at least 3- 5 times a week. Gradually increase your intensity according to your fitness level
  • Consume healthy balanced nutritious meals that are rich in fruits, vegetables and whole-grain foods. Limit the intake of saturated fats, animal products, sweet sugary foods and drinks
  • If you are still smoking, stop smoking today! Smoking cessation is very important in the overall management of patients with hypertension in reducing cardiovascular complications
  • Reduce stress as much as possible. Practice effective stress coping strategies and incorporate meditation, deep breathing and mindfulness in your daily routines. Getting regular physical activity and plenty of sleep may also be helpful. 

If you haven’t check your blood pressure recently, consult your doctor soon and arrange for health screening testing. Hypertension can be managed with both lifestyle and medications. Talk to your doctor to discuss the best treatment for you today

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