Blood pressure, cholesterol and diabetes: the silent three

High blood pressure, raised cholesterol and type 2 diabetes rarely announce themselves. Together they account for most heart attacks, strokes and kidney failure in South African men — and all three respond well to consistent, ordinary care.

High blood pressure

Usually no symptoms at all until damage is done. We diagnose on repeated readings, not a single high one, and sometimes with home readings. Target for most men is under 140/90, lower if you are diabetic. Salt reduction, weight loss, alcohol moderation and regular movement can lower readings meaningfully before medication is even needed. If you are on treatment, bring your tablets and home readings to every visit.

Cholesterol

A simple fasting or non-fasting blood test gives total, LDL, HDL and triglycerides. What matters is your overall cardiovascular risk, not the number alone — we factor in age, smoking, blood pressure, diabetes and family history. Diet and exercise shift triglycerides and HDL most; LDL often needs medication if risk is high. Statins are safe for most men; muscle aches are the common complaint and we can usually manage them by adjusting dose or agent.

Type 2 diabetes and prediabetes

Screen with fasting glucose or HbA1c, especially with a waist over 94 cm, family history, or high blood pressure. Prediabetes is a warning, not a sentence — 5–10% weight loss and regular activity reverse it in many men. Established diabetes needs HbA1c every 3–6 months, plus annual eye, foot, kidney and cholesterol checks. Symptoms worth acting on: excessive thirst, frequent urination, unexplained weight loss, blurred vision, recurrent infections or slow-healing wounds.

How we manage it with you

Regular scheduled reviews with your own numbers tracked over time. Repeat scripts and medication adjustment without a long wait. On-site blood pressure, glucose and cholesterol testing. Practical diet and exercise guidance suited to a working week, not a magazine. Referral to a physician, cardiologist or dietitian where it will add value.