Nearly one out of every four people in India suffers from high blood pressure and yet there are many misconceptions about its implications. Today, in the wake of World Hypertension Day, which is observed on 17th May this year, let us understand in detail the disease, its effects, its harmful implications and statistics. 

This post was complied with expert inputs from Dr. A. B. Mehta, Interventional Cardiologist, Jaslok Hospital, Mumbai.  

Hypertension in adults is blood pressure of more than 140 mm of mercury systolic blood pressure or more than 90 mm of mercury diastolic blood pressure. Diagnosis and treatment is based on two or more blood pressure readings taken on separate occasions. Blood pressure is measured by a mercury sphygmomanometer. Many electronic devices such as finger, wrist and arm monitors are commercially available for monitoring blood pressure at home. These are not as accurate as conventional mercury sphygmomanometers and therefore, home readings should be counter checked regularly.

Hypertension is present in 25% of urban Indians and 10% of rural Indians.  Among cities in India, Mumbai has the highest rates of hypertension – 44% of men and 45% of women silently suffer from high BP as compared to 30% and 33% for men and women from Delhi and 24% and 17% among men and women in Kolkata. India, already the diabetes capital of the world with 32 million persons with diabetes, is projected to have 69.8 million by 2025. The count of “hypertensive” individuals is expected to rise from 118 million in 2000 to 214 million in 2025. 

What harm can a little high blood pressure do? 70% of the above people fall in the Stage I Hypertension category that is Systolic BP between 140 – 159mm of mercury or diastolic BP between 90 -99mm of mercury; and carry a significant risk of developing cardiovascular and cerebrovascular diseases.  “A man of my build needs a slightly higher blood pressure”, is one of the commonest misconceptions. A higher blood pressure is NOT in any way related to physique.  It needs to be treated.

Hypertension is directly responsible for 57%of all stroke deaths and 24% of all coronary heart disease deaths in India. Many people are diagnosed for the first time when they develop some complication related to hypertension.

95% of patients with high blood pressure have ‘Primary Hypertension’ that is - hypertension without any obvious medical cause. Many contributing factors may be present in these patients like obesity, alcohol or tobacco intake, high salt intake, low potassium or calcium intake, psychosocial stress, sedentary lifestyle, socioeconomic status or genetic factors. 

A small number of patients can develop hypertension due to medical conditions like renal artery stenosis (narrowing of the kidney arteries), chronic kidney failure, adrenal gland tumours, pregnancy, drugs, like steroids, among other rarer causes. This is termed as Secondary Hypertension. When a patient is diagnosed with hypertension, he should have some baseline tests done to detect any treatable cause of high blood pressure.

Hypertension is a controllable disease. With simple oral medication, along with diet and exercise, blood pressure can be controlled.  Population-wide decrease in Blood Pressure can prevent 1,51,000 stroke and 1,53,000 coronary heart disease deaths in India each year.   

The sword of blood pressure looms large over the heads of urban Indians.  Since the stress of city life has become unavoidable, we should learn stress management and implement risk factor control.  People with confirmed hypertension should have periodic check-ups and follow-up with medications religiously, as advised.  We may need the assistance of medications but a pill seems truly small when compared to the horrors of a stroke or a heart attack. This World Hypertension Day should be the day that you take charge of controlling your blood pressure, before it begins to control you. 

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