Indians have started to wake up to the risk of diabetes and its ill effects, but high blood pressure (hypertension) is still not talked about enough! Below are all the facts about this silent disease, which only gives symptoms when serious complications arise!
Stats for high blood pressure in India
About 33% urban and 25% rural Indians are hypertensive (have high BP). Of these, only 25% rural and 42% urban Indians are aware of their hypertensive status and are under treatment. Even among young adults and children, high blood pressure is getting commoner!
This is serious because if left untreated, even mild to moderate hypertension can cause CVD (heart disease) in 30% of people and organ damage in 50% of people, within 8-10 years
High blood pressure is the most important modifiable risk factor for coronary heart disease or CVD. which causes heart attack, stroke , heart failure, and kidney failure and is the cause of death in 25% cases in India
What is the normal BP and what blood pressure ranges define prehypertension and hypertension?
Blood pressure is typically recorded as two numbers, written as a ratio like this:120/80. What do these blood pressure numbers mean and how to interpret them? Below are the answers:
Systolic blood pressure: the top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats
Diastolic blood pressure, the bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats
Blood pressure ranges, used to define normal blood pressure and various stages of high blood pressure are the following (expressed in mm of Hg, based on recommendations of the JNC 7,) for adults aged 18 years or older is as follows :
- Normal blood pressure: systolic lower than 120 mm Hg and diastolic lower than 80 mm of Hg
- Prehypertension: systolic 120-139 mm Hg or diastolic 80-89 mm of Hg
- Stage 1 hypertension: systolic 140-159 mm Hg or diastolic 90-99 mm of Hg
- Stage 2 hypertension: systolic 160 mm Hg or greater or diastolic 100 mm of Hg or greater
The classification above is based on the average of 2 or more readings taken at each of 2 or more visits after initial screening (to know more, go to: ‘How to take correct blood pressure reading‘)
Are there any high blood pressure symptoms?
High BP does not give rise to headache or anxiety or any other dependable symptom, so you can not suspect that you have high BP, based on how you feel! High blood pressure, unless it is very high (BP higher than 180/110), does not give rise to any symptoms.
Therefore, only reliable way to know whether you have high BP is by getting your blood pressure taken correctly
Recommendations for screening Indians for high BP
All adults more than 18 years should get their blood pressure checked annually, as per various International guidelines. In fact, evidence is building up that you should get your child’s blood pressure also checked annually!
Pediatric guidelines in the US and many studies in India suggest that children should get BP measured at the age of three. If the BP is found under control, BP should be taken every 2-3 years
What are the bad effects of high blood pressure?
Uncontrolled hypertension can lead to the following complications:
- CVD: which includes
- IHD or CHD (Ischemic Heart Disease or Coronary Heart Disease which can lead to heart attack)
- CAD (Carotid Artery Disease, which can result in stroke)
- PAD (Peripheral Artery disease, which can result in severe pain on walking and gangrene of feet)
- CKD (Chronic Kidney Disease, which can lead to kidney failure)
- Aneurysms, which are sac like ballooning of arteries involving aorta, the biggest artery of the body, arteries supplying the brain etc. , when these rupture it is usually a life-threatening catastrophe
- Heart Failure: Constant task of pumping blood in high resistance vessels (due to high BP) leads to hypertrophy (growth in size) of heart and eventually failure, which leads to severe limitation of activity, irregular heart beats, clot formation etc., any one of which can be life threatening
- Vision loss: Retinal blood vessels get affected and this can cause vision loss
- Higher brain functions/Cognitive functions: high BP can result in decline in brain functions especially memory
Keeping BP in control has the following benefits :
- 35-40% reduction in stroke incidence
- 20-25% reduction in myocardial infarction
- More than 50% reduction in heart failure
How to lower blood pressure
Diabetes, high blood pressure, high blood cholesterol and metabolic syndrome are all linked together. Obesity, unhealthy diet, lack of physical activity , smoking and excessive drinking are the lifestyle factors contributing to all these diseases. Learn how to manage your CVD risk factors
These diseases have a big impact on your risk of CVD, therefore if you get diagnosed with high BP, get your ‘comprehensive heart risk assessment‘ done. Choose lifestyle modifications and drug therapy for these health risks on the basis of your overall heart risk (Calculate your risk of heart attack in next 10 years?)
People who have high blood pressure, may benefit from having a BP apparatus at home and monitoring their BP regularly. To know more, read: ‘Who should get a home BP app?‘
CHECK OUT: Our references for recommendation in heart risk management