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LETTER

LETTER | When too salty kills

Dr Noran Naqiah Hairi et al

Published

LETTER | “More Flavour, Less Salt!” The World Salt Awareness Week falls from March 8 to 14 this year. The aim is to raise awareness of the damaging effect of too much salt on our health.

The campaign is part of the global strategy to reduce salt consumption. Our local study showed that the average salt intake per day among Malaysians was 7.9g in 2017–2018. 

This far exceeded the level recommended by the World Health Organisation (WHO), which is less than 5g per day. One of the global NCD targets by the WHO is to reduce salt intake by 30 percent.

Excessive salt consumption is related to elevated blood pressure or hypertension. 

Blood pressure is expressed with two numbers. The first (systolic) number represents the pressure when the heart contracts, while the second (diastolic) number represents the pressure when the heart rests between beats. The blood pressure is high when the systolic reading is ≥140 mmHg, or the diastolic reading is ≥90 mmHg (or both).

Hypertension is a “silent killer.” Most individuals with hypertension do not have symptoms. Thus, it is essential to measure blood pressure regularly. 

The recent 2019 National Health and Morbidity Survey reported that 30 percent of our adult population had hypertension. What is worrying is that almost half of the respondents do not know that they have the disease. 

If left undetected or uncontrolled, hypertension can lead to heart attack, stroke, heart failure, kidney failure, vision loss, and sexual dysfunction.

With the interrelations between risk factors such as unhealthy diet, obesity, and physical inactivity, there is no wonder why a whopping 1.7 million Malaysians have hypertension, diabetes, and high cholesterol. 

Another local study reported that among our diabetes patients, 85 percent of them had hypertension and 88 percent high cholesterol.

Diverse factors such as diet, physical activity level, body weight, tobacco smoking, alcohol consumption, mental stress, medical conditions, and medications can all affect blood pressure readings. 

Hence, it is not surprising that blood pressure among patients is often difficult to control. 

Among diabetic hypertensive patients in Malaysia, blood pressure trends have mostly stagnated despite more than half of them were given two or more blood pressure medications. 

Moreover, only a quarter of them achieved the clinically recommended blood pressure goal.

What can we do to prevent hypertension or optimise blood pressure control?

  1. Know the numbers – only by checking our blood pressure regularly can we know about our blood pressure status.

  2. Reduce our dietary salts intake. Replace salt with spices, fresh herbs, garlic and black pepper. Cut back on sauces – soya sauce, salad dressing and others. Avoid foods high in salts such as instant noodles, fast foods, smoked, salted or canned meat, fish or poultry.

  3. Home-cooked food – get creative in the kitchen and try out new recipes.

  4. Adopt a healthy diet rich in fruit, vegetables, whole grains, legumes, seeds, nuts, and fish and low in red meat, sweets, salts, and fats.

  5. Stop smoking and limit alcohol consumption for non-Muslims.

  6. Exercise regularly. Resistance training using weight (eg, bodyweight exercise) and aerobic exercise (eg, brisk walking, cycling, jogging) help.

  7. For individuals on blood pressure medications, do adhere to the prescribed treatment plans.


DR NORAN NAQIAH HAIRI, DR MOY FOONG MING and DR WAN KIM SUI are from the  Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya. 

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.