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Heart health: Understanding hypertension and protecting your cardiovascular wellness

Heart disease and hypertension are among the most common health concerns in South Africa. Many people are unaware they even have high blood pressure — often called the “silent killer” — because it may not cause symptoms until complications develop.

This article explains what hypertension is, why it is widespread in South Africa, how lifestyle shapes heart health, and the practical steps individuals and families can take to protect their cardiovascular wellbeing.

Why heart health matters

Your heart works continuously - beating around 100 000 times a day - to circulate oxygen and nutrients throughout the body. When blood pressure rises or arteries become damaged, the heart must work harder, increasing the risk of:

• Heart attack
• Stroke
• Kidney damage
• Vision problems
• Heart failure
• Peripheral vascular disease

Protecting your heart means protecting every organ in your body.

Hypertension in South Africa

Hypertension is extremely common locally. According to The Heart and Stroke Foundation South Africa:

• More than 1 in 3 adults have high blood pressure.

Risk factors include family history, older age (with nearly 8 in 10 South Africans over 55 affected), physical inactivity, a high-salt/low-fruit-and-vegetable diet, excess body weight, heavy alcohol use, and smoking.

High blood pressure is often called the ‘silent killer’ because it usually presents with no symptoms or warning signs. As a result, more than half of people with hypertension do not realise they have it.

This makes education, screening and early action essential.

What is blood pressure?

Blood pressure measures the force of blood pushing against artery walls.

Two numbers are used:

• Systolic (top number): pressure when the heart beats
• Diastolic (bottom number): pressure when the heart relaxes

A reading of 120/80 mmHg is considered normal.

Common symptoms (often there are none)

Hypertension frequently causes no symptoms, which is why regular screening is crucial. When symptoms occur, they may include:

• Headaches
• Dizziness
• Fatigue
• Blurred vision
• Nosebleeds
• Palpitations

These are usually signs of advanced or dangerously high blood pressure.

Major causes and risk factors

1. High salt intake

South Africans consume far more salt than recommended, mostly from processed foods such as:

• Fast foods
• Sausages and cured meats
• Instant noodles
• Chips
• Bread (a major contributor of hidden salt)

2. Unhealthy diet patterns

High intake of:

• Fried foods
• Sugary drinks
• Excess carbohydrates
• Low vegetable and fruit consumption

These contribute to hypertension, high cholesterol and weight gain.

3. Stress and sedentary lifestyle

Many South Africans work long hours, commute far distances, and have limited time for physical activity, increasing cardiovascular risk.

4. Genetics

Hypertension often runs in families.

5. Smoking and alcohol

Both can raise blood pressure and damage blood vessels.

6. Obesity

Excess weight significantly increases cardiovascular strain.

How to protect your heart

1. Follow South Africa’s heart-healthy eating pattern

Eat more:

• Vegetables and fruits
• Wholegrains (brown rice, oats, maize, whole-wheat bread)
• Lean proteins (chicken, fish, legumes)
• Healthy fats (olive oil, nuts, seeds, avocado)

Reduce:

• Salt
• Sugary drinks (one of South Africa’s biggest contributors to weight gain)
• Deep-fried or fatty foods
• Processed meats
• Excess bread, pastries and white starches

2. Be salt smart

The World Health Organization recommends less than 5 grams of salt per day.

Practical ways to cut salt:

• Avoid adding salt at the table
• Rinse canned foods before use
• Choose low-salt stock cubes or herbs instead of seasoning powders
• Limit fast food
• Check labels for “sodium” content

3. Move more

Exercise strengthens the heart and improves circulation.

Aim for:

• 150 minutes of moderate activity per week
• Walking, dancing, jog-walking, household chores, garden work
• Strength training 2–3 times a week

Movement can be simple, affordable and safe — especially important in communities where gyms may be inaccessible.

4. Maintain a healthy weight

Reducing excess body weight lowers blood pressure and reduces strain on the heart.

5. Prioritise good sleep

Poor sleep raises stress hormones and disrupts blood pressure regulation.

• Keep a regular sleep schedule
• Reduce evening screen time
• Keep your sleep space cool (important in South Africa’s climate)

6. Manage stress

Chronic stress is a major contributor to hypertension.

• Deep breathing
• Light walking
• Journaling
• Prayer or meditation
• Talking to loved ones
• Limiting caffeine

7. Limit alcohol

Follow recommended guidelines and avoid binge drinking.

8. Quit smoking

Smoking damages blood vessels and dramatically increases the risk of heart attack and stroke.

Common myths about heart health

Myth 1: If I feel fine, my blood pressure is fine.
Hypertension is often symptomless.

Myth 2: Only older adults get high blood pressure.
It affects all ages — even young adults.

Myth 3: Sea salt or Himalayan salt is healthier.
All salts raise blood pressure equally.

Myth 4: Bread is harmless.
Bread is one of the largest contributors of hidden salt in South Africa.

Frequently asked questions (FAQs)

Q: How often should I check my blood pressure?
At least once a year, or more frequently if you’re over 40 or have risk factors.

Q: Can stress alone cause high blood pressure?
Stress contributes, but diet and lifestyle play equal roles.

Q: Does hypertension go away on its own?
Rarely. It requires consistent lifestyle management or medication.

Q: Can I exercise if I have high blood pressure?
Yes — in fact, exercise often lowers blood pressure. Avoid intense exercise until cleared by a healthcare provider.

Practical heart health checklist

• Eat vegetables at two meals a day
• Limit salt intake
• Swap sugary drinks for water
• Move for 30 minutes daily
• Manage stress with relaxation methods
• Avoid tobacco
• Keep alcohol within safe limits
• Maintain a healthy weight
• Monitor blood pressure annually
• Prioritise sleep

When to seek medical help

Seek urgent care if you experience:

• Chest pain
• Severe shortness of breath
• Sudden weakness or slurred speech
• Vision changes
• Fainting
• Severe headache with confusion

These may indicate a medical emergency.

References

• WHO - Hypertension Fact Sheet
• Heart and Stroke Foundation South Africa (n.d.) Blood Pressure

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