For many people, high blood pressure does not trigger immediate warning signs, it’s just a number on a screen. But if left untreated, it quietly places a constant strain on the heart and blood vessels, increasing the risk of severe and long-lasting cardiovascular issues.
In Malaysia, nearly one in three adults has hypertension, 1 yet many remain unaware of their health condition. This “silent killer” often begins with vague symptoms, resulting hidden damage building up over time.
Dr Gary Lee Chin Keong, Consultant Cardiologist and Electrophysiologist at Sunway Medical Centre, Sunway City (SMC) draws attention to the importance of understanding the high blood pressure, its symptoms, and also the health numbers in order to safeguard your heart on World Hypertension Day.
How High Blood Pressure Silently Strains the Heart
The heart and blood vessels work together as a continuous circulation system, with the heart acting as a pump and the vessels as a network of pipelines. When blood pressure remains high over an extended time, the heart is forced to work harder to circulate blood through the body.
Dr Gary explains,
“At first, the heart adapts by becoming thicker and stronger. However, unlike skeletal muscle, this thickening is not beneficial in the long run. The constant strain causes the heart muscle to stiffen, reducing its ability to fill and pump efficiently.”
One of the earliest signs of this process is left ventricular hypertrophy (LVH), a thickening of the heart’s main pumping chamber. As the muscle wall thickens, the chamber has less room to fill with blood, and the heart itself may struggle to receive enough oxygen. Eventually, it becomes stiffer, less flexible, and more vulnerable to failure.
What makes LVH especially concerning is that it can develop long before symptoms appear. In many cases, it is only picked up through tests such as an echocardiogram, which allows doctors to see structural changes in the heart.
Why Symptoms Often Come Too Late
Many people with hypertension do not realise they have heart damage until it’s too late because they feel completely well even as critical structural changes are taking place in the heart.
Symptoms such as chest pain, shortness of breath, palpitations, dizziness, or fainting are often dismissed as stress, fatigue, or indigestion. By the time these symptoms become more obvious, complications may already be advanced.
This is why regular health screening is critical, even in the absence of symptoms. Long-term high blood pressure increases the risk of heart failure, stroke, heart attack, kidney disease, and abnormal heart rhythms.
Dr Gary also highlights the link to atrial fibrillation,
“Hypertension does not act alone. It triggers changes across multiple organs, affecting not only the heart, but also the brain, kidneys, and blood vessels throughout the body.”
Atrial fibrillation, an irregular heart rhythm, can disrupt normal blood flow and increase the risk of blood clots, which may lead to stroke, another serious health condition that is of the common cause of death in Malaysia
A Growing Concern Among Younger Malaysians
Dr Gary notes a worrying trend, more young Malaysians are being diagnosed with hypertension and heart disease.
“About twenty years ago, hypertension was mostly thought to be a problem for older population. Today, I have patients who are only in their 20s or 30s,” he says.
Modern lifestyles are playing a major factor in developing primary hypertension. This trend is caused by long working hours, chronic stress, inadequate sleep, lack of exercise, smoking, excessive salt intake and high consumption of processed foods.
Obesity and diabetes further increase the risk, creating what Dr Gary describes as a “dangerous cluster” of cardiovascular risk factors.
“Many Malaysians are not only developing hypertension earlier but also living with its effects for a longer period of time. This makes complications more likely to appear at a younger age,” he notes.
Screening Early Can Change the Outcome
The good news is that early detection can make a real difference. Dr Gary encourages Malaysians to start learning about their health numbers as early as their 20s.
Basic checks such as blood pressure, cholesterol, blood sugar, and body weight can help identify risks early. Depending on individual risk profiles, doctors may recommend further tests such as ECG, Echocardiography, Stress tests, CT Cardiac.
When hypertension is detected early followed by intervention, some changes to the heart can be slowed or even partially reversed, and may even improve over time. This usually involves a combination of medication, dietary changes, exercise, weight control, smoking cessation, stress management, and regular checkups and follow-ups. Dr Gary emphasized that patients should not stop the medications without first consulting their treating doctor.
Know Your Numbers, Protect Your Heart
For Dr Gary, the key takeaway is simple but powerful: know your numbers and take action.
“Don’t wait for symptoms to tell you something is wrong. The earlier you detect high blood pressure, the better your chances of protecting your heart,” he says.