By Dr Fatimah Arshad, Professor of Nutrition, Dietetics & Health, Universiti Kebangsaan Malaysia

Do you recall the song that goes “The head bone’s connected to the neck bone …”? The connection goes all the way down to the thigh bone and the toe bones, and is a great analogy for stress, hypertension and cardiovascular health. These are three factors so intimately intertwined that you cannot mention one without the other two.

Stress is one of the causes of raised blood pressure, but it does not cause hypertension. Hypertension is consistently or permanently elevated blood pressure. The causes vary but the following factors are almost always present in people suffering from hypertension:

  1. They have immediate family members who have already been diagnosed with hypertension;
  2. They like salty food;
  3. They seldom exercise;
  4. They claim to be “always stressed”!
  5. They drink;
  6. They smoke;
  7. They’re overweight.

Currently, about three to four million Malaysians suffer from hypertension, where their blood pressure ranges between 140/90 and 160/100. This is the initial stage; normal blood pressure is less than 140/90.

The higher our blood pressure, the greater our risk of stroke, renal and cardiovascular disease. This is because sustained or prolonged increased blood pressure affects the interior structure of blood vessels that are found in the brain, retina, kidneys and heart.

People suffering from hypertension are also at risk of developing atherosclerosis, the build-up of plaque in their arteries. Plaque build-up narrows the artery; the heart has to pump harder to get the blood through, as arterial walls thicken and begin to further resist blood flow. The heart has to pump even harder, which can lead to the enlargement of the left ventricle. A stroke or heart attack may result.

Some people – the “Type A personalities” – feel constantly stressed. We need to recognize that while some stress is real, some is caused by factors within our control. However, learning to identify and manage these stress-inducing factors may take time and effort. We may also need expert medical help.

A more immediate step we can take is to manage our food intake differently, most notably reducing the amount of salt we consume every day. We can do this by:

  1. Reducing the use of sauces, seasoning cubes or powders in our cooking;
  2. Reducing the use of canned or processed meats;
  3. Soaking ikan bilis or salted fish in water to remove excess salt, prior to cooking;
  4. Reducing the consumption of pickles, chutneys, crisps, crackers and snacks;
  5. Using natural spices and flavours from lemon grass, daun kesum, coriander leaves, saffron, bunga kantan, daun limau purut, onions, ginger, spring onions, celery, lime or lemon juice, tamarind, and fruit like mangoes and pineapples to make food more palatable.

In addition to lowering salt consumption, hypertension patients need to reduce their weight. Weight loss is associated with 66% reduction in the incidence of hypertension. Therefore, eating plans that emphasize lower calories and low fat intake, fruits and vegetables, low glycaemic index and glycaemic load, wholegrain products are highly recommended by dietitians to help you reduce weight. A note of caution, be careful when you choose wholemeal products because not all of them have low glycaemic index and glycaemic load.

These steps, accompanied by a change in attitude and the true desire for a healthy lifestyle, will empower us in our efforts to achieve a better quality of life. There are myriad advantages to adjusting our diet – it just takes a little effort. Healthwise, the rewards are certainly worth it.

Psychologically, a safe, controlled loss in weight usually gives us a boost. We feel better about ourselves, and step out with more confidence.

Remember – we hold the key to keeping ourselves fit, healthy and happy. If we don’t take responsibility and do it for ourselves, nobody else will.


Loving yourself is the heart of the matter, and it starts with loving your health. “Love Your Heart, Love Your Self” is a series of articles brought to you by Gardenia on your health, with some practical ways to stay on the right track through stress management, proper diet, weight management and nutritional choices. Dr Fatimah Arshad, Professor of Dietetics, Nutrition & Health, is a respected Dietitian in academia, and was extensively involved in the development of Gardenia’s low-G.I, low-G.L. bread, Breakthru.

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