Hypertension: why one Moroccan in three doesn’t know they have it

Arterial hypertension affects roughly a third of Moroccan adults over forty. Its clinical signature is also its danger: it is asymptomatic. No pain, no discomfort, nothing that prompts a visit. Meanwhile, the pressure on the arterial wall thickens it, stiffens it and lays the groundwork for the stroke or kidney failure of the following decade.

What “140/90” actually means

The first figure measures pressure as the heart contracts, the second as it relaxes. Hypertension starts at 140/90 mmHg, confirmed across at least two separate consultations. A single reading is never enough: the stress of a waiting room can lift systolic pressure by twenty points, a phenomenon so common it has a name — white coat effect.

Three days of home readings beat one perfect reading in the surgery. The monitor in your living room tells the truth the doctor’s cuff distorts.

Five levers before medication

• Cut salt to under 5 g a day — most of it comes from bread, tinned food and olives, not the salt shaker.
• Thirty minutes of brisk walking, five days a week: 5 to 8 mmHg off systolic pressure.
• Losing 5% of body weight often does more than half a tablet.
• Limit heavily sweetened tea: sugar acts on blood pressure through the insulin pathway.
• Treat loud snoring: sleep apnoea is a widely under-diagnosed cause of resistant hypertension.

If after three months of rigorous lifestyle change the pressure stays above 140/90, medication is not a failure: it is the logical next step. Current drugs are taken once a day, and their side effects are vastly smaller than those of a stroke at sixty.