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National Health and Morbidity Survey 2019 Technical Report − Volume I 028 The prevalence of raised blood glucose amongst those not known to have diabetes in males and females were 9.2% (95% CI: 7.92, 10.64) and 8.6% (95% CI: 7.64, 9.65) respectively. Indians had the highest prevalence at 12.9% (95% CI: 7.94, 20.37), followed by Malays [10.6% (95% CI: 9.34, 11.92)], Others [6.7% (95% CI: 4.31, 10.31)], Chinese [6.6% (95% CI: 4.92, 8.83)], Bumiputera Sabah [6.4% (95% CI: 4.66, 8.78)] and Bumiputera Sarawak [4.3% (95% CI: 2.45, 7.46)]. Raised blood glucose amongst those not known to have diabetes was more common among widow(er) / divorcee [12.3% (95% CI: 9.65, 15.56)], those with no formal education [10.6% (95% CI: 7.32, 15.21)], retiree [12.9% (95% CI: 9.68, 16.92)] and those from the B40 group [9.3 % ( 95% CI: 8.18, 10.57)]. 4.2 Hypertension Contributors to this section: Nur Liana Ab Majid, Syarifah Nazeera Syed Anera, Halizah Mat Rifin, Hasimah Ismail, Muhammad Fadhli Mohd Yusoff, Feisul Idzwan Mustapha, Arunah Chandran, Masni Mohamad, Fatanah Ismail, Ahmad Hazri Ilyas, Wan Shakira Rodzlan Hasani, Jane Ling Miaw Yn, Tania Gayle Robert Lourdes, Thamil Arasu Saminathan, Ahzairin Ahmad, Chang Li Cheng, Rizawati Ramli Objectives General Objective To determine the prevalence of hypertension in Malaysia. Specific Objectives

  1. To determine the prevalence of overall raised blood pressure by socio-demographic sub-groups
  2. To determine the prevalence of known hypertension by socio-demographic sub-groups
  3. To determine the prevalence of raised blood pressure amongst those not known to have hypertension by socio- demographic sub-groups Methods The hypertension module was carried out on all respondents aged 18 years old and above. Data was collected through questionnaire and blood pressure was measured using the Omron Digital Automatic Blood Pressure Monitor Model HEM-907. Three readings were taken and an average of the second and third reading was computed for the findings. Variable Definition
  4. Overall raised blood pressure was defined as known hypertension and raised blood pressure amongst those not known to have hypertension.
  5. Known hypertension was defined as self-reported of being told to have hypertension by a doctor or assistant medical officer.
  6. Raised blood pressure amongst those not known to have hypertension was defined as the respondent who was not known to have hypertension and had systolic blood pressure measurement of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg [6]. Findings A total of 10,463 respondents responded to the hypertension module. Overall Raised Blood Pressure The overall prevalence of hypertension among adults aged 18 years and above in this survey was 30.0% (95% CI: 28.57, 31.50). The prevalence of overall raised blood pressure increased with age. The prevalence was reported to be 5.7% (95% CI: 4.09, 7.82) among those aged 20 - 24 years old and the highest prevalence of 81.7% (95% CI: 77.03, 85.55) among those 75 years old and above. The prevalence was higher in the rural areas [32.8% (95% CI: 30.03, 35.63) compared to urban areas [29.2% (95% CI: 27.57, 30.97)]. There was a large variation between states, with the highest prevalence of 40.5% (95% CI: 35.54, 45.72) in Sarawak, followed by Kelantan [37.1% (95% CI: 33.26, 41.11)] and Perak [35.5% (95% CI: 30.14, 41.23)] while the lowest was Wilayah Persekutuan Putrajaya [24.7% (95% CI: 20.61, 29.36)]. The prevalence in males and females was 30.3% (95% CI: 28.22, 32.50) and 29.7% (95% CI: 27.98, 31.46) respectively. In terms of the main ethnic groups, Bumiputera Sarawak had the highest prevalence at 46.8% (95% CI: 39.65, 54.16), followed by Malays at 32.2% (95% CI: 30.58, 33.92), Bumiputera Sabah at 31.0% (95% CI: 25.19, 37.40), Indians at 30.6% (95% CI: 25.73, 35.91), Chinese at 28.1% (95% CI: 24.51, 31.99) and other ethnicities at 15.2% (95% CI: 11.29, 20.09). The prevalence of overall hypertension was highest among widow(er) / divorcee at 62.5% (95% CI: 57.83, 67.04), those without formal education 48.7% (95% CI: 40.90, 56.58), retirees 66.9% (95% CI: 60.44, 72.79) and those from the B40 group [30.8% (95% CI: 28.97, 32.61)].

Non-Communicable Diseases: Risk Factors and other Health Problems 029 Known Hypertension The prevalence of known hypertension was 15.9% (95% CI: 14.79, 17.05). The prevalence increased with age, from 1.5% (95% CI: 0.83, 2.51) in the age group 25-29 years old, and the highest prevalence of 65.0% (95% CI: 59.27, 70.23) among the 75 years and above. The prevalence of known hypertension was higher in the rural areas [17.2% (95% CI: 15.37,19.29)] compared to urban areas [15.5% (95% CI: 14.21,16.89)]. There was a large variation between states; the highest prevalence 22.7% (95% CI: 16.74, 30.02) in Perak, followed by Negeri Sembilan [19.8% (95% CI: 14.58, 26.31)] and Sarawak [19.6% (95% CI: 16.07, 23.58)], while the lowest being Selangor [12.7% (95% CI: 10.61, 15.16)]. The prevalence among males and females were 14.1% (95% CI: 12.74, 15.58) and 17.8% (95% CI: 16.39, 19.26) respectively. By ethnicity, Bumiputera Sarawak had the highest prevalence [21.3% (95% CI: 16.28, 27.40)] followed by Indians [19.6% (95% CI: 16.16, 23.50)], Chinese [17.8% (95% CI: 14.83, 21.21)], Bumiputera Sabah [17.1% (95% CI: 13.43, 21.50)], Malays [16.6% (95% CI: 15.35, 17.88)] and others [3.6% (95% CI: 2.36, 5.51)]. The prevalence of known hypertension was highest among widow(er) / divorcee [45.3% (95% CI: 41.12, 49.59)], those with no formal education [34.1% (95% CI: 27.83, 40.98)], retiree [48.3% (95% CI: 41.90, 54.85)] and those from the B40 group [16.3% (95% CI: 14.90, 17.85)]. Among those with known hypertension, 89.4% claimed to be on oral anti-hypertensive drugs within the past 2 weeks, 88.1% had received specific diet advice from healthcare personnel, 73.4% claimed to have been advised by healthcare personnel to lose weight and 81.1% had been advised to be more physically active or start exercising. Among the known hypertensives, 15.8% of respondents reported taking herbal and traditional medicine.
With regards to their usual place of treatment, more than half of them sought treatment at MOH health clinics (67.8%), followed by MOH hospitals (15.0%), private clinics (12.6%), and private hospitals (2.1%). About 1.2% self-medicated by purchasing medications directly from pharmacies, 0.2% went to the traditional and complementary medicine practitioners and 1.2% did not seek any treatment. Raised Blood Pressure Amongst Those Not Known to Have Hypertension Amongst those not known to have hypertension, the prevalence of raised blood pressure was 14.1% (95% CI: 13.13, 15.19). There was a general increasing trend in prevalence with age, from 4.6% (95% CI: 3.17, 6.65) in the 20-24 year old age group, reaching a peak of 22.6% (95% CI: 18.48, 27.35) among the 45-49 years old. The prevalence was higher in the rural areas [15.5% (95% CI: 13.85, 17.36)] compared to urban areas [13.7% (95% CI: 12.55, 15.00)]. There was a large variation between states; the highest prevalence of 21.4% (95% CI 17.22, 26.18) were in Kelantan and Sarawak [21.0 (95% CI: 17.33, 25.16)], followed by Terengganu [18.9% (95% CI: 15.63, 22.75)], while the lowest was Pulau Pinang [9.1% (95% CI: 5.77, 14.01)]. It was higher in males [16.2% (95% CI: 14.59, 17.99)] compared to females [11.9 (95% CI: 10.77, 13.15)]. By ethnicity, Bumiputera Sarawak had the highest prevalence of 25.5% (95% CI: 21.34, 30.22), followed by Malays [15.6% (95% CI: 14.41, 16.98)], Bumiputera Sabah [13.9% (95% CI: 10.65, 17.90)], other ethnicities [11.6% (95% CI: 8.09, 16.24)], Indians [11.0% (95% CI: 7.73, 15.47)], and lastly Chinese [10.3% (95% CI: 8.01, 13.15)]. The prevalence was highest among widow(er) / divorcee [17.2% (95% CI: 14.19, 20.75)], those with primary education [17.5% (95% CI: 15.05, 20.23)], and those from the B40 group [14.4% (95% CI: 13.26, 16.71)]. 4.3 Hypercholesterolaemia Contributors to this section: Halizah Mat Rifin, Masrol Hafizal Ismail, Abdul Muneer Abdul Hamid, Nur Liana Ab Majid, Hasimah Ismail, Muhammad Fadhli Mohd Yusoff, Feisul Idzwan Mustapha, Rizawati Ramli, Chang Li Cheng, Arunah Chandran, Masni Mohamad, Fatanah Ismail, Ahmad Hazri Ilyas, Wan Shakira Rodzlan Hasani, Jane Ling Miaw Yn, Tania Gayle Robert Lourdes, Thamil Arasu Saminathan, Ahzairin Ahmad Objectives General Objective To determine the prevalence of hypercholesterolaemia in Malaysia. Specific Objectives

  1. To determine the prevalence of overall raised blood cholesterol by socio-demographic sub-groups
  2. To determine the prevalence of known hypercholesterolaemia by socio-demographic sub- groups
  3. To determine the prevalence of raised total cholesterol amongst those not known to have hypercholesterolaemia by socio-demographic sub-groups

National Health and Morbidity Survey 2019 Technical Report − Volume I 030 Methods The hypercholesterolemia module was carried out on all respondents aged 18 years old and above. Data was collected through questionnaires and measurement of finger-pricked for total cholesterol using the CardioChek® portable blood test system. Variable Definition

  1. Overall raised blood cholesterol was defined as known hypercholesterolaemia and raised total cholesterol amongst those not known to have hypercholesterolaemia.
  2. Known hypercholesterolaemia was defined as self- reported or being told to have hypercholesterolaemia by a doctor or assistant medical officer.
  3. Raised total cholesterol amongst those not known to have hypercholesterolaemia was defined as the respondent who was not known to have hypercholesterolaemia and had total cholesterol of 5.2mmol/L or more [7]. Findings A total of 10,466 respondents responded to the hypercholesterolaemia module. Overall Raised Blood Cholesterol Prevalence The prevalence of overall raised blood cholesterol in this survey was 38.1% (95% CI: 36.15, 40.00). The highest prevalence of overall raised blood cholesterol was among the 70 - 74 years age group [63.4% (95% CI: 56.57, 69.65)]. The highest prevalence of overall raised blood cholesterol was recorded in Kelantan [51.1% (95% CI: 44.58, 57.58)] while the lowest was in Johor [28.9% (95%CI: 23.40, 35.08)]. The prevalence among females was higher [44.5% (95% CI: 42.15, 46.80)] compared to males [32.0% (95% CI: 29.73, 34.36)]. Overall raised blood cholesterol was more common among Malays [43.5% (95% CI: 41.46, 45.57)], widow(er) / divorcee [58.5% (95% CI: 54.26, 62.59)], those with primary education [43.6% (95% CI: 39.64, 47.59)], retirees [62.5% (95% CI: 55.40, 69.02)] and those from the M40 group [40.4% (95% CI: 37.11, 43.84)]. Known Hypercholesterolaemia The prevalence of known hypercholesterolaemia was 13.5% (95% CI: 12.51,14.51). Almost half of the respondents from the 70-74 age group [45.5% (95% CI: 39.02, 52.20)] were aware that they had hypercholesterolaemia. The highest prevalence of known hypercholesterolaemia was recorded in Perak [20.2% (95% CI: 15.79, 25.53)], while the lowest was in Sabah [8.4% (95% CI: 6.35, 10.95)]. The prevalence of known hypercholesterolaemia among females was higher [15.1% (95% CI: 13.98, 16.35)] compared to males [11.9% (95% CI: 10.61, 13.38)]. Known hypercholesterolaemia was more common among Indians [18.9% (95% CI: 15.18, 23.28)], widow(er)s / divorcees [34.1% (95% CI: 30.23, 38.21)], those with no formal education [21.7% (95% CI: 16.70, 27.77)] and retirees [42.0% (95% CI: 35.56, 48.70)]. Among those with known hypercholesterolaemia, 80.1% claimed to be on oral drugs within the past 2 weeks, 87.7% claimed they had received specific diet advice from healthcare personnel, 73.9% claimed to have been advised by healthcare personnel to lose weight and 82.2% had been advised to be more physically active or to start exercising. 18.1% of respondents reported taking herbal and traditional medicine to treat their condition. Most respondents sought treatment at Ministry of Health (MOH) clinics (67.1%), MOH hospitals (14.6%), private clinics (12.8%) and private hospitals (3.3%). About 1.0% self-medicated by purchasing medications directly from pharmacies and 0.3% preferred to see traditional, herbal and complementary medicine practitioners. 0.8% did not seek any treatment for their condition. Raised Total Cholesterol Amongst Those Not Known to Have Hypercholesterolaemia For this survey, the prevalence of raised total cholesterol amongst those not known to have hypercholesterolaemia was 24.6% (95% CI: 23.03, 26.19). The highest prevalence of raised total cholesterol amongst those not known to have hypercholesterolaemia was recorded among those in the 50-54 years age group [36.0% (95% CI: 31.93, 40.28)]. The highest prevalence was in Kelantan [40.5% (95% CI: 34.28, 46.98)] while the lowest was in WP Labuan [14.7% (95% CI: 10.92, 19.53)]. The prevalence among females was higher [29.3% (95% CI: 27.35, 31.41)] compared to males [20.1% (95% CI: 18.19, 22.11)]. Raised total cholesterol was more common among Malays [28.8% (95% CI: 26.91, 30.66)], married adults [26.2% (95% CI: 24.34, 28.11)], those with secondary education [25.1% (95% CI: 23.11, 27.14)], unpaid workers / homemakers [30.7% (95% CI: 27.69, 33.90)] and those from the M40 group [27.2% ( 95% CI: 24.25, 30.41)].
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