Regular checkups are vital for patients with blood pressure surge in the mornings, writes Kasmiah Mustapha
FAILURE to control their condition often puts hypertension patients at risk. In addition to not complying with their medication, they also do not monitor their blood pressure.
To have better control of this condition, they need regular monitoring, once in the morning and once at night.
It is especially important to check in the morning as blood pressure tends to increase due to the release of hormones such as adrenaline and noradrenaline in the body to boost energy.
Morning blood pressure surge increases the risk of cardiovascular events for hypertension patients.
Studies have found that patients with morning hypertension have a 78 per cent risk of stroke. It is also linked to changes in heart size and rhythm which may lead to heart attacks or heart failure. Patients are also at risk of damage to the blood vessels.
Malaysian Society of Hypertension (MSH) president Datin Dr Chia Yook Chin says morning blood pressure surge occurs when there is a spike in the levels and usually when the condition is uncontrolled.
If the blood pressure level is more than 135/85 mmHg between 6am and noon, it indicates a morning blood pressure surge. For hypertension patients, this puts them at risk of stroke or worse, sudden death.
“While many may be aware of hypertension, the morning blood pressure surge is still relatively unheard of. If you don’t have hypertension, the surge will not create problems. But people with the condition are at risk of cardiovascular events. In fact, most cases of stroke and heart attack that are linked to hypertension occur early in the morning. This suggests a strong link between a morning blood pressure surge and cardiovascular risks. It is important that hypertension patients monitor their blood pressure in the morning.”
Dr Chia says the best time to check one’s pressure is within two hours of waking up, as this is when blood pressure is at its peak.
“Morning blood pressure has a serious impact when the condition is uncontrolled. They must have a low reading in the morning to ensure it is under control. Otherwise, the chances of it coming down during the day are not good. To reduce the risk, patients need to be on medication that provides 24-hour blood pressure control.”
She says based on MSH’s data in 2011, while 90 per cent of hypertension patients were treated, only 26 per cent had it well-managed. It means only one in four patients have their condition under control.
“Hypertension is a powerful risk predictor of stroke, heart attack, heart failure and kidney damage. It has been shown that hypertension is the most important cause of premature death worldwide, with 9.5 billion deaths every year. It is estimated that by 2025, 1.6 billion people worldwide will be living with hypertension”
HOME BLOOD PRESSURE MONITOR
Dr Chia says it is important for patients to have home blood pressure monitors so they can have regular checks, at least twice a day, to optimise control and assess the effectiveness of their medication.
“They must do home blood pressure reading every morning because if they wait to do it at the doctor’s office, it would not be the same reading. Based on the readings, the doctor may need to adjust the treatment management.”
She adds that one of the issues in managing hypertension is that many patients do not comply with treatment as they think the medication damages the kidney.
“This is not true. A patient will have damaged kidneys if he has uncontrolled blood pressure for long, not the medication. Some think they do not have hypertension because they don’t have symptoms such as headache but most people with the condition have no signs or symptoms even when their pressure is high. So, it is important to have regular blood pressure checks. With early detection and proper management, it reduces the risk of complications.”
Pfizer Malaysia, in partnership with MSH and the National Stroke Association of Malaysia, recently launched The Morning Hype campaign to raise awareness of the morning blood pressure surge and its link to stroke. The campaign, which ends in October, focuses on educating hypertension patients on the importance of having 24-hour control through regular blood pressure checks.
Pfizer Malaysia senior product physician Dr Gayatri Gunasagaran says, following the 38th annual meeting of the Japanese Society of Hypertension last year, medical experts revealed that there is a lack of awareness in monitoring and managing morning blood pressure surge among Asians.
“There have been numerous clinical trials which have established a link between morning blood pressure surge and stroke. So, it is crucial to educate hypertension patients in Malaysia on morning blood pressure surge and its correlation to stroke. The first step is through regular home blood pressure monitoring, especially in the morning,” she says.
In Malaysia, the prevalence of hypertension among adults is at 30 per cent. The Health Ministry is taking steps to reduce the number to 24 per cent by 2025 in line with the national target for non-communicable diseases prevention and control.