High Blood Pressure

NST: First the bad news: One in three Malaysians suffers from high blood pressure and less than a third are aware of their illness.
What is also alarming is that only a small fraction of the eight million Malaysians are keeping their hypertension under control.
Now the good news: A recent study showed that lives can be saved and heart attacks and strokes prevented by using a combination of new drugs.
National Heart Institute senior consultant cardiologist and department of cardiology head Datuk Seri Dr Robaayah Zambahari said hypertension was called the "silent killer" as there were usually no symptoms.
For adults aged 18 years and above, normal blood pressure should be 130/85 mmHg. A person is confirmed to be suffering from high blood pressure if his blood pressure reading on two or more occasions is 140/90 mmHg.
High blood pressure occurs when the force of blood against the artery walls is too strong.
Low blood pressure is an abnormal condition where a person’s blood pressure is much lower than usual, causing symptoms such as dizziness or lightheadedness.
Dr Robaayah said blood pressure was closely associated with the risk of cardiovascular disease. The higher the blood pressure, the greater the chance of heart attack, heart failure, stroke and kidney disease.
But clinical trials have shown that the risk of a stroke can be reduced by 35 to 40 per cent, heart attacks by 20 to 25 per cent and heart failure by more than 50 per cent if those suffering from hypertension are treated early.
While mild high blood pressure could be reduced by dietary changes and regular exercise, she said the majority of people suffering high blood pressure needed medication.
A recent Anglo-Scandinavian Cardiac Outcomes Trial or Ascot study revealed that many lives could be saved every year if a combination of newer drugs for high blood pressure were used.
Traditional drugs for treating high blood pressure are diuretics to remove excess fluid from the body and a beta blocker which reduces the strength of the heart beat.
The newer drugs, ACE inhibitors and calcium channel blockers, work in different ways but help blood vessels to relax so that less pressure is needed to pump blood.
Dr Robaayah, who attended the European Society of Cardiology’s annual conference in Stockholm two weeks ago, said the results of the study showed that heart attacks and strokes could be cut by half with treatment.
She, however, said the newer drugs were slightly more expensive than standard treatments.
"The practice of medicine today should be guided by evidence — evidence of risk of the disease and the safety and benefit of the different options of treatment."
She also stressed the importance of clinical trials, the results of which could be applied to clinical practice.
Kuala Lumpur Hospital consultant pulmonary and critical care physician Datuk Dr Jeyaindran Sinnadurai said some Malaysian doctors familiar with the Ascot study were already prescribing a calcium channel blocker-based regimen to patients.
"Government hospitals will not have problems dispensing the newer drugs as they are available in pharmacies."
It is learnt that the Malaysian Clinical Practice Guidelines of Management of Hypertension published in 2002 would be updated with the new findings.