Hypertension: The silent killer – Consumers Association Penang

World Hypertension Day is observed annually on May 17 with the aim of raising awareness on hypertension and spreading knowledge on this common cardiovascular condition. It was initiated by the World Hypertension League (W.H.L.) which is a non-profit international organization founded on January 4, 1984, dedicated to preventing and controlling hypertension.

Hypertension, or high blood pressure, is a chronic condition where the blood force against artery walls is consistently high. Known as the “silent killer,” as it often has few or no symptoms, regular monitoring is essential.

The theme for World Hypertension Day 2025 is “Measure Your Blood Pressure Accurately, Control It, Live Longer!” The aim is to highlight the importance of better prevention, detection and treatment of high blood pressure, as hypertension is a condition associated with increased risk for stroke, kidney failure, premature death and disability.

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 are suffering from 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.

Hypertension in Malaysia has seen a steady increase, particularly among those under 40, with some patients even in their twenties. This shift is due to a complex interplay of genetic predisposition, lifestyle factors, and dietary habits. The increasing prevalence of hypertension is attributed to various behavioral risk factors such as unhealthy diet, smoking, harmful use of alcohol, inadequate physical activity and exposure to persistent stress. The risk also increased among those with other co-morbidities such as diabetes.

The relationship between cardiovascular diseases and elevation in blood pressure in relation to salt is currently a major focus of scientific research. Scientists believe that sodium increases blood pressure because sodium attracts water and causes fluid retention. The additional fluid retained expands the volume of blood in the arteries, which then puts pressure on the walls of the blood vessels, resulting in elevated blood pressure.

Past study found that Malaysians consume 8.7 grams of salt daily, which is 1.7 times higher than the World Health Organisation’s recommendation of 5 grams a day. Table salt (sodium chloride) is the major source of sodium in the Malaysian diet. One teaspoon or 5g of salt provides 2,000 mg of sodium. Awareness of the effects of sodium on health, as well as controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians.

There are various reasons why Malaysians are consuming too much sodium:

Unhealthy modern eating habits which rely on convenience foods (canned foods, instant foods, fast foods, hawker foods) and processed foods (salty snacks, commercially prepared breads) which have high sodium content. For example, a single packet of instant noodles already contains 2,000mg of sodium which is the maximum allowable daily intake of sodium.
A lot of sodium additives are hidden in processed foods. Some examples are monosodium glutamate or MSG (a flavour enhancer), sodium saccharin (a sweetener), sodium phosphates (emulsifiers stabilizers, buffers), sodium caseinate (a thickener and binder) and sodium nitrite (a preservative). There are over 40 types of sodium-based additives allowed in processed foods.
Salty or hidden high-salt seasoning like sauces and seasoning cubes are added to food during home and restaurant cooking.
Habitual and excessive intake of local high salt foods like salted fish, salted eggs and salted vegetables.
Modern food processing methods. Salt is sometimes added to canned and frozen fruits to prevent darkening of some fruits and to add to the flavour. For example, canned and bottled citrus drinks are sometimes buffered with sodium citrate.

Excessive sodium intake has also been associated with a number of health conditions other than raised blood pressure. It also increases the risk of stomach cancer and the rate of deterioration in kidney function of patients with renal disease; it is also associated with urinary stones; and it may aggravate asthma and osteoporosis.

Although it is important that consumers are advised to consume less sodium or choose low-salt foods, the widespread use of sodium in processed foods and foods prepared away from home or eaten outside is a major barrier to achieving any meaningful reduction in dietary sodium intake. Therefore, there is a need to reduce the sodium content of processed foods and drinks.

As May 17 has been dedicated as World Hypertension Day and in view of the escalating number of hypertension cases among Malaysians, the Consumers’ Association of Penang calls on the government to:

Make it mandatory for food manufacturers to show the amount of sodium on the labels of food products.
Stop the advertisements of food products that contain high levels of sodium such as instant noodles.
Launch a massive campaign to encourage consumers to engage in physical activities to reduce obesity, which can lead to high blood pressure.

Meanwhile consumers are advised to:

Avoid consuming processed foods.
Use less salt and seasonings in cooking at home. Instead use various natural herbs and condiments to add flavour to the food.
Choose food with less salt and sauces when purchasing foods away from home, either as takeaways or when dining out.
Lobby the government for compulsory labeling of sodium in processed foods.
Read the nutrition information panel (NIP) and find out the amount of sodium in foods intended to be purchase. Some imported foods or foods produced for export have sodium amounts listed on their labels)

Mohideen Abdul Kader
President,
Consumers’ Association of Penang

Press Statement, 17 May 2025