By Dr Wan Kim Sui / Professor Dr Noran Naqiah Hairi / Professor Dr Moy Foong Ming

17th May 2021 marks World Hypertension Day with a theme "Measure Your Blood Pressure Accurately, Control It, Live Longer."

The aim is to educate the public and increase awareness on the importance of hypertension (high blood pressure) and its complications.

According to the National Health and Morbidity Survey in 2019, three in every ten Malaysian adults have hypertension, translating to a staggering 6.4 million Malaysians.

It is also worrying when almost half of our fellow Malaysians are not aware that they have hypertension.

In other words, three million Malaysian adults are living their daily lives without knowing that they have elevated blood pressure.

Hypertension is dubbed the "silent killer" because many individuals with hypertension do not have symptoms. They do not know about their conditions unless they have their blood pressure measured. This group of individuals may include us, our family members and friends.

Blood pressure is expressed as a measurement with two numbers, with one value at the top (systolic) and one at the bottom (diastolic). The normal value for adults is below 140 mmHg for systolic and below 90 mmHg for diastolic blood pressure.

Accurate measurement of blood pressure can be conducted by trained healthcare professionals, often using a mercury sphygmomanometer. Alternatively, a properly calibrated automated blood pressure monitor can also be used.

It is crucial for those using automated blood pressure monitors at home or work to calibrate the device as per recommendations by the manufacturer.

Here are some tips for measuring your blood pressure accurately. Avoid drinking caffeinated beverage or smoke 30 minutes before the measurement.

Sit quietly for at least five minutes before measuring the blood pressure. During the measurement, sit on a chair with feet on the floor and arm supported so that the elbow is at about heart level.

One practical way to quickly and properly size a blood pressure cuff is to use a cuff covering two-thirds of the distance between the elbow and shoulder.

Do not talk during the measurement and have your blood pressure measured twice, with a brief break in between. If the readings differ by five points or more, do a third measurement.

Monitoring and controlling our blood pressure are important. If left unchecked, hypertension can lead to complications such as heart attack, stroke, kidney failure, vision loss and sexual dysfunction. Moreover, hypertension is a significant cause of premature death worldwide.

Managing one's high blood pressure can be challenging. A review study concluded that about 70% of hypertensive patients require at least two types of blood pressure-lowering medications to achieve treatment targets.

Many factors such as diet, physical activity levels, body weight, tobacco smoking, alcohol consumption, mental stress, other medical conditions and medications can affect blood pressure readings.

Among diabetic hypertensive patients in Malaysia, a local study found that only 1 in 4 of them attained the desired blood pressure goal.

What can you do to prevent hypertension or optimize blood pressure control?

1. Check, track and monitor your blood pressure regularly.

2. Reduce dietary salt intake by cutting back on sauces and avoiding foods high in salts such as fast foods, instant noodles, canned and junk foods.

3. Adopt a healthy diet rich in fruits, vegetables, whole grains, legumes, seeds, nuts, and fish and low in red meat, sweets, salts and fats.

4. Be physically active regularly.

5. Stop smoking and limit alcohol consumption.

6. For individuals with hypertension, do adhere to the prescribed treatment plans. Also, be more receptive to adding on medications by your doctor.

(Dr Wan Kim Sui, Professor Dr Noran Naqiah Hairi and Professor Dr Moy Foong Ming, Center for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.)