Hypertension, a silent killer that increases risk of cardiac ailments, stroke among youth

Hyderabad: September 29 is observed as World Heart Day. But, did you know that one of the main culprits that worsen heart ailments is high blood pressure or high BP, which mostly goes uncontrolled, undetected and without symptoms?

Uncontrolled hypertension coupled with cardiac ailments can enhance the risk of brain stroke, kidney damage, diabetes etc.

Like other lifestyle diseases, even people in their 30s and 40s are getting affected by hypertension. Some decades ago, high BP was mainly common among senior citizens.

India ranked 49 globally in the prevalence of hypertension, according to the World Health Organisation (WHO). The treatment coverage of hypertension in India is just about 30 per cent, less than the global treatment average of 42 per cent.

Masked Vs white coat hypertension

Blood pressure is written by two numbers. The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (diastolic) number represents the pressure in the vessels when the heart rests between beats. A reading of 130/90 is considered normal BP.

Hypertension (high blood pressure) is when the pressure in the blood vessels is too high, at 140/90 mmHg or higher. It is a common condition but can be serious if not treated. The main challenge is the lack of symptoms, which is why regular blood pressure checkups are important.

“Hypertension can be masked (when the BP is normal in the clinic or office but higher at home), or white coat hypertension (when the BP is elevated at the office or at the hospital but normal at home or outside). Undetected hypertension consists of adults whose BP is not diagnosed by a doctor but whose BP levels conform to hypertension that is equal or more than 140/80,” said Dr L Sudarshan Reddy, senior general physician and diabetologist at Yashoda Hospitals.

Age and genetics among risk factors

Speaking about the risk factors of high blood pressure, Dr Sudarshan Reddy said, “Risk factors include old age such as 60 years and above, genetics or a family history of BP, co-existence of diabetes and kidney ailments, being overweight or obese, excessive stress, sedentary lifestyle, an unhealthy diet high in salt and saturated fat and trans fats, smoking and drinking alcohol. However, nowadays, with the increase in sedentary lifestyle, stressful jobs and bad food habits, patients are getting high BP even in their 30s and 40s.”

Extreme high BP can cause headaches, blurred vision

Most people with hypertension don’t feel any symptoms. Very high blood pressure can cause headaches, blurred vision, chest pain and other symptoms. People with very high blood pressure (usually 180/120 or higher) may experience symptoms including severe headaches, chest pain, dizziness, difficulty breathing, nausea, vomiting, blurred vision or other vision changes, anxiety, confusion, buzzing in the ears, nosebleeds, and abnormal heart rhythm. The only way to detect hypertension is to have a health professional measure blood pressure.

Uncontrolled hypertension may lead sudden death

Experts point out that hypertension is not a stand-alone ailment. It can cause several health complications including serious damage to the heart. Excessive pressure can harden the arteries, decreasing the blood and oxygen flow to the heart.

The elevated pressure and reduced blood flow in turn can cause chest pain, also called angina, or heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater will be the damage to the heart.

Hypertension can also lead to heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs and irregular heartbeat, which can lead to sudden death.

Hypertension can also burst or block arteries that supply blood and oxygen to the brain, causing a stroke. In addition, hypertension can cause kidney damage, leading to kidney failure.

Tips for controlling hypertension

A few methods to decrease hypertension include:

- eating more vegetables and fruits.

- limiting salt intake to around two grams per day.

- avoiding saturated fats, quitting tobacco, minimising alcohol intake and, most importantly, stress.

- becoming more physically active, which can include walking, running, swimming, cycling, dancing etc. Adults should aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week.

- performing strength-building exercises two or more days a week.

- losing weight if one is overweight or obese.

- regularly checking the blood pressure.

- taking medicines prescribed by one’s healthcare professional.

Check BP at home too

“For borderline hypertension, lifestyle change is advised as a mode of treatment. But if BP is more or the patient has other co-morbid conditions, then doctors may recommend appropriate and effective medicines, which should be ideally taken lifelong unless the physician decides to alter or minimise the dosage,” said Dr Reddy, and added that nowadays ambulatory or 24-hours home blood pressure monitoring is helpful in detecting hypertension.

The recommended blood pressure goal may depend on what other health conditions the patients have. The blood pressure goal should be less than 130/80 if one has cardiovascular disease (heart disease or stroke), diabetes (high blood sugar), chronic kidney disease, and/or is at high risk for cardiovascular diseases. For most people, the goal is to have a blood pressure of less than 140/90.

WHO’s alarming statistics on hypertension

- High blood pressure contributes to 19 per cent of deaths globally.

- An estimated 1.28 billion adults aged between 30 and 79 years worldwide have hypertension. Two-thirds of them live in low and middle-income countries.

- An estimated 46 per cent of adults with hypertension are unaware of their condition.

- Less than half of adults (42 per cent) with hypertension are diagnosed and treated.

- Every eighth person in the world has uncontrolled hypertension.

- Approximately, one in five adults (21%) with hypertension has it under control.