'Don’t wait for warning signs – there may not be any': Get tested now for high blood pressure, says doctor

One in three South Africans over the age of 30 is living with high blood pressure — and many don’t know it.

Before World Hypertension Day on Saturday, a leading vascular surgeon at Lenmed eThekwini Hospital and Heart Centre Dr Vinesh Padayachy urged South Africans to get tested for high blood pressure.

“Don’t wait for warning signs — there may not be any. A five-minute blood pressure test can save your life. Hypertension is manageable but only if you know you have it. Know your numbers. That’s where prevention starts,” he said.

“Hypertension is the silent killer because it creeps in unnoticed. By the time many patients see me, they’ve already lost something — a limb, kidney function or even their independence.”

Padayachy warned that ignoring the condition was costing South Africans dearly.

“You can’t feel your blood pressure rising. Over time it attacks your heart, brain, kidneys and limbs. Stroke, aneurysms, amputations — these are often the end result of untreated high blood pressure.”

A combination of poor diets, sedentary lifestyles, chronic stress, high salt intake, alcohol abuse and low access to health care fuels the epidemic locally. Genetics and cultural norms also play a role.

“People are coming in with major vascular disease in their 40s. That’s young. This is preventable but only if we catch it early and the only way to do that is to check your blood pressure regularly.”

Padayachy recommended South Africans check their blood pressure at least once a year from the age of 18 and more often if they have family history or risk factors.

“Lifestyle changes can make a real difference. Cutting salt, eating whole foods, exercising 30 minutes a day — these aren’t small tips; they’re life-saving strategies.”

Misinformation and denial were a challenge, he said. “Too many people stop their medication when they feel better, not realising hypertension doesn’t just go away. We must treat it consistently as we do diabetes or HIV.

“When blood can’t reach your brain or legs because arteries are narrowed or blocked, the outcome is tragic. Stroke is one of the leading causes of death and disability in South Africa and high blood pressure is the biggest driver of that.”

He stressed the urgent need for improved collaboration between GPs, clinics and specialists. “Primary health care must do more than diagnose. We need long-term follow-up, support for adherence and better access to medication, especially in rural areas,” he said.

South African women face disproportionately high rates of hypertension. Pharma Dynamics’ Scientific Division spokesperson Ingrid Singels said hypertension in women increased from 31% in 1998 to 48% in 2016, according to national health data.

“This rise has been driven in part by unhealthy dietary habits, such as high consumption of sugary drinks, processed foods and salt rich meals contributing to widespread obesity.

“Furthermore, socioeconomic disparities result in unequal access to healthcare, nutritious food and consistent follow-up care, making targeted interventions essential,” she said.

Even in women without a family history of high blood pressure, developing it during pregnancy significantly raises their risk of hypertension later in life.

“After menopause the drop in oestrogen reduces nitric oxide — which normally helps keep blood vessels relaxed — and leads to increased blood pressure. This is why postmenopausal women often display higher systolic blood pressure than men of the same age, along with stiffer arteries and increased renin-angiotensin system activity contributing to this shift.

“It’s also crucial for women to engage in regular screenings, including blood pressure and cholesterol monitoring. Your health-care practitioner should also check for hormonal fluctuations which can affect blood pressure.”

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