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Kuala Lumpur, March 28: When it comes to one’s health, moderation is key – especially when it comes to lifestyle practices that can lead to the escalation of the three highs: high cholesterol, high blood sugar level and high blood pressure that have been rather prevalent in Malaysia as of late. In the 2019 National Health and Morbidity Survey (NHMS), it was reported that 8.1 per cent of the adult population in Malaysia have all three risk factors for diabetes, hypertension and high cholesterol – all of which are main non-communicable diseases resulting from the three highs. These numbers are increasing at an alarming rate each year and should be paid attention to before it progresses to an untreatable stage. This World Health Day, Sunway Medical Centre Velocity (SMCV) is diving deeper into these issues with guidance from its consultants.  

What are the three highs and when should we look out for them?

Dr Lim Soo Jin, Consultant Internal Medicine Physician and Nephrologist in SMCV shares that the three highs occur as a result of unhealthy diets and sedentary lifestyles. Those with a strong family history of the disease are more susceptible to it as well. 
“The three highs are usually experienced by patients above the age of 40, but poor lifestyle habits may cause them to present early. These three highs are the major risk factors for stroke, ischemic heart disease and chronic kidney disease, all of which can lead to other health problems if taken lightly,” Dr Lim said. 
It is also important to note that symptoms of the three highs can be subtle, and regular health screenings to check blood pressure, sugar and cholesterol levels are key. 
“Symptoms of very high blood pressure can include headaches, vision problems, chest pain and difficulty in breathing, while those with high blood cholesterol may have eye signs such as Xanthelasma (yellowish-white lumps of fatty material accumulated under the skin) or Arcus Senilis (a white, light grey or bluish arc visible above and below the outer part of the cornea). Patients with high blood sugar will have increased thirst, frequent urination, fatigue, nausea and vomiting, shortness of breath and stomach pains,” he adds. 

How do the three highs affect the heart and the brain?

If left untreated, these three highs can lead to other life-threatening conditions such as Acute Coronary Syndrome (ACS) which is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. This will result in heart attack conditions such as Acute Myocardial infarction, Acute Subendocardial Myocardial Infarction and unstable angina.
Dr Tee Chee Hian, Consultant Cardiologist and Internal Medicine Physician at SMCV explains that this can be seen in symptoms such as chest pain upon exertion, reduced effort tolerance, tiredness, dizziness, near fainting situations and palpitation. 
“If these three highs are not managed, it will cause blockage in the coronary artery and reduce blood flow to the heart muscle. Severe cases will experience a sudden loss of consciousness (as the heart stops pumping) and require immediate medical attention,” Dr Tee said. 
In terms of brain function, the three highs also present a strong impact, according to Dr Kok Chin Yong, Consultant Neurologist and Internal Medicine Physician at SMCV.
“Blood pressure elevation induces abnormal changes and remodelling of the blood vessel wall, weakening it and leading to impaired blood flow, especially to the deep brain structures. Abnormally high sugar levels cause direct damage to these structures and can result in confusion, abnormal movement disorder and seizures,” Dr Kok explains. 
He notes, however, that not all elevated blood pressure leads to hypertension, but is a warning sign that cannot be ignored – which is why he stresses the importance of paying attention to any symptoms and getting clarification from a consultant that can be useful in identifying any underlying conditions.  
“Early diagnosis is crucial. Treating the three highs early prevents stroke and dementia by preventing degeneration of both brain cells and blood vessels in the brain,” he said.   

Taking proactive steps for better outcomes 

Dr Lim notes that Malaysia has good health facilities, which patients should make use of to maintain their well-being. 
“Blood pressure monitoring and health screenings are easily available even on a district level so Malaysians can get their health checked with ease.”
Dr Tee concurs, elaborating on the importance of good healthy diets and regular exercise. 
“A healthy and balanced diet and regular exercise will help to reduce the three highs, for example, a diet rich in vegetables and fruits, with less processed and fast food. Regular exercise is another way to control three highs. Not to forget, smoking cessation is also a good way to help to reduce chances of Acute Coronary Syndrome.”
For an improved quality of life, Dr Kok urges patients to be aware of any changes in the body, no matter how small, as they can have a larger impact on their health than they know it. 
“Never second guess your symptoms. Conditions such as high blood pressure and diabetes are the main risk factors for stroke in Malaysia, and hypertension is a silent killer as well. Healthcare facilities can play a role in providing regular education through social media and awareness campaigns. That way, people can easily get up-to-date information and be constantly reminded of the most important aspect of their life – their health.”

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