By Dr Aung Tun
I MAGINE carrying a ticking time bomb inside your chest silent, invisible, giving no warning signs. You feel perfectly fine. You go about your daily routine. But inside, the pressure is building, quietly damaging your heart, your brain, and your kidneys. This is the reality for millions of people living with hypertension, or high blood pressure the world’s most common yet most underestimated medical condition.
As
the world observes World Hypertension Day on 17 May 2026 under the theme
“Controlling Hypertension Together: Check Your Blood Pressure Regularly, Defeat
the Silent Killer”, it is time for every one of us young or old, urban or rural
to pay attention. This article explains what hypertension is, why it matters,
and most importantly, what you can do about it.
1.
What Is Hypertension?
Blood
pressure is the force that your blood exerts against the walls of your arteries
as your heart pumps it around the body. It is measured in millimetres of
mercury (mmHg) and recorded as two numbers: systolic pressure (when the heart
beats) over diastolic pressure (when the heart rests between beats). A healthy
reading is generally around 120/80 mmHg.
Hypertension
is defined as having a blood pressure consistently at or above 130/80 mmHg.
When the pressure in the arteries is persistently too high, the heart has to
work harder than normal, and over time, the blood vessels, heart, brain,
kidneys, and eyes begin to suffer damage. Most people with high blood pressure
feel nothing at all hence its well-deserved nickname, “the silent killer”.
2.
Types of Hypertensions
Not
all high blood pressure is the same. There are two main types, and
understanding them helps with the right approach to treatment.
Primary
(Essential) Hypertension
This
is by far the most common type, accounting for about 90–95 per cent of all
cases. It has no single identifiable cause, but develops gradually over many
years through a combination of genetic predisposition, unhealthy lifestyle
choices, ageing, and environmental factors. It cannot be “cured”, but it can be
very effectively managed.
Secondary
Hypertension
Secondary
hypertension has a specific underlying cause, such as kidney disease, hormonal
disorders (like an overactive thyroid or adrenal gland tumour), sleep apnoea,
or certain medications (including oral contraceptives, anti-inflammatory drugs,
and decongestants). Treating the root cause can often bring blood pressure back
to normal. Secondary hypertension tends to appear suddenly and be more severe.
There
are also special categories worth noting, including isolated systolic
hypertension (common in older adults), white-coat hypertension (elevated
readings only in a clinical setting), and masked hypertension (normal readings
at the clinic but high at home).
3.
Global Burden: A Crisis in Every Country
High
blood pressure is not a disease of the wealthy or the elderly alone. It is a
global crisis.
•
An estimated 1.4 billion people worldwide live with hypertension that is,
roughly one in three adults globally.
•
Despite the availability of effective and affordable treatments, only about one
in four people with hypertension have their blood pressure adequately
controlled.
•
Hypertension is the leading preventable cause of premature death worldwide,
responsible for over 10 million deaths annually.
•
It is the primary driver of heart attacks, strokes, and kidney failure the
three leading causes of death and disability globally.
•
Two-thirds of people with hypertension live in low- and middle-income countries
(LMICs), where healthcare access and awareness remain limited.
•
About half of all people with hypertension are completely unaware of their
condition, going undiagnosed for years.
The
economic toll is enormous. The costs of stroke rehabilitation, dialysis for
kidney failure, and cardiac surgery place a crushing burden on families and
health systems alike. Experts estimate that each year of inaction costs the
global economy hundreds of billions of dollars in lost productivity and
healthcare expenditure.
WHO
calls hypertension “one of the most important preventable causes of premature
cardiovascular disease and mortality worldwide” and has set a global target of
reducing its prevalence by 33 per cent by 2030.
4.
Myanmar’s Situation: A Growing Challenge
Myanmar
is not immune to the global hypertension epidemic. National survey data paint a
sobering picture of the NCD burden within our country, including the rising
prevalence of high blood pressure across all age groups and regions.
The
2024 Myanmar STEPS Survey the most comprehensive national NCD risk factor
assessment in a decade covered 52 townships and 8,252 adults aged 18-69 years.
The
latest findings from the *Myanmar STEPS Survey 2024* reveal a significant
public health challenge regarding hypertension among adults aged 18-69. The
data highlights not only a high prevalence of high blood pressure but also
critical gaps in diagnosis and effective treatment.
*Current
Situation Overview**
*High
Prevalence: * Nearly **one in four adults (24.4 per cent) ** in Myanmar suffers
from hypertension. The prevalence is notably higher in men (27.3 per cent)
compared to women (21.1 per cent).
*The
“Silent” Gap: * While 58.1 per cent of hypertensive individuals have been
previously diagnosed, a significant portion remains unaware of their condition
until tested.
*Treatment
Hurdles: * Only **43.6 per cent** of those with hypertension are currently
receiving medical treatment. There is a distinct gender disparity here, with
women (54.1 per cent) being much more likely to seek or receive treatment than
men (36.5 per cent).
*Low
Control Rates: * Most concerning is that only **21.6 per cent** of hypertensive
patients have their blood pressure effectively controlled. This suggests that
even among those diagnosed and treated, the management of the condition remains
insufficient to prevent longterm complications like stroke or heart disease.
*Contributing
Risk Factors*
The
survey also identifies several lifestyle factors contributing to these high
rates:
*Dietary
Salt: * 18.3 per cent of the population regularly adds salt or salty sauce to
their food.
*Physical
Inactivity:* 25.9 per cent of adults do not meet the recommended physical
activity levels.
*Obesity:*
26.8 per cent of the population is overweight (BMI \ge 25 kg/m^2), a primary
driver for raised blood pressure.
The
2024 STEPS Survey underscores the urgent need for enhanced public health
interventions in Myanmar. Improving screening coverage, especially for men, and
ensuring better access to effective, long-term treatment are essential steps to
reducing the national burden of cardiovascular diseases.
5.
Signs, Symptoms, and Warning Signals
The
most dangerous thing about hypertension is that it usually has no symptoms. A
person can walk around for years with dangerously high blood pressure without
feeling a thing. This is why checking your blood pressure regularly even when
you feel well is so critically important.
However,
when blood pressure reaches very high levels, some people may experience:
•
Severe headaches, especially at the back of the head
•
Blurred or double vision
•
Nausea or vomiting
•
Dizziness or light-headedness
•
Chest pain or tightness
•
Shortness of breath
•
Nosebleeds (epistaxis)
•
Ringing in the ears (tinnitus)
•
Facial flushing or a feeling of heat
IMPORTANT:
These symptoms usually appear only during a hypertensive crisis (blood pressure
≥180/120
mmHg), which is a medical emergency. Do NOT wait for symptoms to check your
blood pressure. By the time symptoms appear, serious damage may already be
underway.
6.
Complications and Side Effects of Uncontrolled Hypertension
When
high blood pressure is left untreated or poorly managed, the consequences are
serious and wide-ranging. The extra force placed on artery walls causes them to
thicken, harden, and narrow a process called atherosclerosis. Over time, this
damages vital organs throughout the body.
Heart
•
Heart attack (myocardial infarction): when the blood supply to the heart muscle
is blocked
•
Heart failure: when the heart becomes too weak or too stiff to pump blood
effectively
•
Left ventricular hypertrophy: the heart muscle thickens and enlarges, reducing
efficiency
Brain
•
Stroke: either haemorrhagic (burst blood vessel) or ischaemic (blocked blood
vessel) often leading to paralysis,
speech loss, or death
•
Transient ischaemic attacks (TIAs) or “mini-strokes”
•
Transient ischaemic attacks (TIAs) or “mini-strokes”
•
Vascular dementia: cognitive decline due to reduced blood flow to the brain
TO
BE CONTINUED
#TheGlobalNewLightOfMyanmar
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