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Tag: #Wellness

  • How Hypertension Slowly Reshapes the Heart Without Warning Signs

    How Hypertension Slowly Reshapes the Heart Without Warning Signs

    High blood pressure often does not produce immediate warning signs and is frequently perceived as just a number on a monitor. However, if left untreated, it can quietly place continuous strain on the heart and blood vessels, significantly increasing the risk of serious and long-term cardiovascular complications.

    In Malaysia, nearly one in three adults is affected by hypertension, yet many remain unaware of their condition. Often referred to as a “silent killer,” it typically develops without clear symptoms, while hidden damage gradually accumulates over time. In conjunction with World Hypertension Day, Consultant Cardiologist and Electrophysiologist at Sunway Medical Centre, Sunway City (SMC), Dr Gary Lee Chin Keong, highlights the importance of understanding high blood pressure, recognising its symptoms, and being aware of key health indicators to protect heart health.

    The heart and blood vessels function as a continuous circulatory system, with the heart acting as a pump and the vessels forming a network of pathways. When blood pressure remains consistently high over time, the heart is forced to work harder to circulate blood throughout the body. Dr Gary explains that the heart initially adapts by becoming thicker and stronger, but this adaptation is not beneficial in the long term. Over time, the persistent strain causes the heart muscle to stiffen, reducing its ability to fill and pump blood efficiently.

    One of the earliest manifestations 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 capacity to fill with blood, and the heart may struggle to receive adequate oxygen. Eventually, it becomes stiffer, less flexible, and more vulnerable to failure. LVH is particularly concerning because it can develop long before any symptoms appear and is often only detected through diagnostic tests such as an echocardiogram, which reveals structural changes in the heart.

    Many individuals with hypertension remain unaware of underlying heart damage because they feel well even as significant internal changes are taking place. Symptoms such as chest pain, shortness of breath, palpitations, dizziness, or fainting are often mistaken for stress, fatigue, or indigestion. By the time these symptoms become more apparent, complications may already be advanced. This is why regular health screening is essential, even in the absence of symptoms, as long-term high blood pressure increases the risk of heart failure, stroke, heart attack, kidney disease, and abnormal heart rhythms.

    woman patient suffering from heart attack

    Dr Gary also highlights the link between hypertension and atrial fibrillation, an irregular heart rhythm that can disrupt normal blood flow and increase the risk of blood clot formation, potentially leading to stroke, one of the leading causes of death in Malaysia. He explains that hypertension does not only affect the heart, but also has widespread effects on the brain, kidneys, and blood vessels throughout the body.

    He further notes a concerning trend of increasing hypertension and heart disease among younger Malaysians. Previously regarded as a condition affecting older adults, hypertension is now being diagnosed more frequently in individuals in their 20s and 30s. Modern lifestyle factors such as long working hours, chronic stress, inadequate sleep, lack of exercise, smoking, excessive salt intake, and high consumption of processed foods are major contributors. Obesity and diabetes further increase the risk, creating what Dr Gary describes as a “dangerous cluster” of cardiovascular risk factors. As a result, complications are appearing earlier and affecting individuals over a longer period of time.

    The good news, however, is that early detection can significantly improve outcomes. Dr Gary encourages Malaysians to begin monitoring their health numbers as early as their 20s, including blood pressure, cholesterol, blood sugar, and body weight. Depending on individual risk profiles, doctors may also recommend further investigations such as ECG, echocardiography, stress tests, or CT cardiac scans. When hypertension is detected early and managed appropriately, changes to the heart can be slowed and, in some cases, partially reversed or improved over time.

    Management typically involves a combination of medication, dietary changes, regular exercise, weight control, smoking cessation, stress management, and consistent follow-up care. Dr Gary also emphasises that patients should not discontinue medication without first consulting their doctor.

    He concludes with a simple but powerful reminder: knowing your numbers and taking timely action are essential steps in protecting heart health. Early detection remains the most effective way to reduce the risks associated with high blood pressure.

  • Healthy Ramadan: Keeping Your Gut Happy While Fasting

    Healthy Ramadan: Keeping Your Gut Happy While Fasting

    You wait all day for that first bite, as the aroma of freshly prepared kuih, rich gravies and sweet drinks fills the table. After hours of fasting, it is tempting to indulge, but by midnight many find themselves feeling bloated, uncomfortable or struggling with heartburn once again.

    For many, Ramadan is a time of spiritual renewal and an opportunity to embrace a more mindful and balanced approach to physical well-being. However, some individuals may experience digestive discomfort during the fasting month. Acid reflux, bloating, constipation and fatigue can occur due to dietary choices made between iftar and sahur. Dr Sheikh Anwar Abdullah, Consultant Gastroenterologist and Hepatologist at Sunway Medical Centre, Sunway City, encourages those observing the fast to view Ramadan as an opportunity to reset their gut health rather than strain it.

    He explains that the digestive system benefits from a period of rest during fasting, as the body produces less acid and experiences reduced inflammatory triggers, which can improve gut health. However, these benefits are often undone by overeating at iftar or neglecting proper hydration and fibre intake.

    Research supports what many experience firsthand, showing an increase in gastrointestinal complaints such as bloating, acid reflux and constipation during Ramadan. These issues are commonly linked to heavy meals, oily and spicy foods, dehydration and long gaps between eating. According to Dr Sheikh Anwar, the main contributors include overeating at iftar, consuming deep-fried or spicy foods, insufficient water intake and low fibre consumption. Reduced physical activity due to altered sleep patterns and lower energy levels also plays a role, as it slows digestion and worsens constipation.

    Skipping sahur or opting for fast food may seem convenient, but it often leads to further digestive issues. Dr Sheikh Anwar advises starting the day with a balanced, slow-digesting meal that can sustain energy and support gut health. An ideal sahur includes complex carbohydrates such as oats or brown rice, protein sources like eggs, fish or tofu, and water-rich fruits such as watermelon or cucumber. Yogurt may also benefit gut health due to its probiotics, provided there is no lactose intolerance. Spicy and greasy foods should be avoided as they can irritate the stomach lining and increase the risk of reflux later in the day.

    When breaking fast at iftar, it is important to ease the stomach back into digestion. Sugary drinks, excessive fried food and salty dishes may be satisfying initially but often lead to bloating and indigestion. It is recommended to start with water and a few dates, followed by a short pause, such as performing Maghrib prayers, before continuing with a proper meal. Eating slowly and choosing a balanced plate consisting of complex carbohydrates, lean protein and healthy fats can help support digestion.

    Late-night eating is another common concern during Ramadan. Moreh, the post-tarawih supper often shared among family and friends, is a cherished tradition in Malaysia but should be practised in moderation. Keeping the meal light and allowing a gap of two to three hours between the last meal and bedtime can help reduce acid reflux and other digestive issues.

    Hydration is essential, as constipation is one of the most frequent complaints during Ramadan and is often caused by inadequate fluid intake. Many people consume less than their daily water requirements during the fasting month. Proper hydration not only supports digestion but also helps prevent headaches and fatigue. It is advisable to consume at least two to 2.5 litres of water between iftar and sahur, sipping regularly instead of drinking large amounts at once. Including water-rich fruits and limiting caffeine intake can further help prevent dehydration.

    While fasting is generally safe for most healthy adults, individuals with pre-existing gastrointestinal conditions should take extra care. Conditions such as ulcerative colitis, duodenal ulcers, upper gastrointestinal bleeding and moderate-to-severe liver cirrhosis may be aggravated during fasting and require careful monitoring as well as guidance from healthcare professionals. Those taking gastric medication are advised to consume it about 30 minutes before sahur for optimal effect. If symptoms such as persistent abdominal pain, vomiting, diarrhoea or blood in the stool occur, it is important to seek medical attention and not feel pressured to continue fasting.

    Fibre plays a crucial role in maintaining digestive health, yet many Malaysians do not meet the recommended daily intake of fruits and vegetables. This shortfall can worsen constipation and bloating during Ramadan. Fibre supports bowel regularity, helps lower cholesterol, stabilises blood sugar levels and promotes a feeling of fullness. Increasing fibre intake gradually through fruits, vegetables, legumes and whole grains is recommended to avoid gas and discomfort.

    Ramadan should not be seen as a temporary reset but as an opportunity to build lasting healthy habits. Dr Sheikh Anwar encourages Malaysians to continue practising mindful eating, staying hydrated and spacing out meals even after the fasting month ends. Older adults, in particular, should ensure adequate intake of protein and fibre to maintain muscle strength and digestive health.

    This Ramadan, the focus should go beyond satisfying cravings at iftar and instead prioritise what truly nourishes the body. A healthier gut supports a better fasting experience and a more meaningful period of reflection. Fasting and health go hand in hand, and it is important to eat in moderation, stay well hydrated and listen to the body. If something feels wrong, it is crucial to seek medical attention promptly rather than ignore the symptoms.