New Delhi: One of the most widespread non-communicable diseases in the world is persistent hypertension. According to the World Health Organisation (WHO), over 1.13 billion individuals worldwide, or 24 per cent of the adult population, were predicted to have hypertension in 2019. In low- and middle-income countries, there are higher prevalence rates than in other areas and nations.
Research indicates that just 12 per cent of India’s 220 million hypertensive persons have their blood pressure under control. Young Indians are becoming more and more likely to have hypertension. The prevalence of hypertension among young adults (aged 18 to 30) in Delhi’s metropolitan districts was reported to be around 9.9 per cent in a study that was published in the Indian Journal of Community Medicine in 2020.
Shockingly, even high school children are falling prey to issues arising from high blood pressure. To get a sense of why there are rising instances of hypertension among younger Indians, ETHealthworld, on this year’s World Hypertension Day, caught up with cardiologists who answered the most frequently asked questions about hypertension on the internet.
Risk factors for developing hypertension at young age
“The most important reason we are finding in our country is a bad lifestyle,” said Dr Rahul Gupta, Cardiologist, Apollo Hospitals, Navi Mumbai. He explained the statement in detail: 95 per cent of high blood pressure cases that happen are known as essential hypertension, which has a direct relationship with lifestyle.
Poor sleeping habits among youngsters are also potentially a major cause of hypertension. Poor sleeping routines can later lead to conditions like sleep apnea, which is one of the reasons for high blood pressure. Apart from this, experts suggest that a high level of stress is also a contributor. “The younger generation is also going through a lot of stress. Plus, there is a lack of exercise; physical activities have gone down. Most of the people are sitting all throughout the day. And sitting is considered the new smoking,” added Dr Gupta.
Long hours of sitting have been associated with several health issues, according to research. They include obesity and the metabolic syndrome, a group of ailments marked by elevated blood pressure, excessive blood sugar, extra body fat around the waist, and dangerous cholesterol levels. Many companies in the West are hell-bent on removing chairs from the office to make people not stationed at one place. Apart from smoking and excessive consumption of alcohol, rising levels of obesity and increased salt intake in general in society are factors behind the rise in hypertension in youngsters.
Poor dietary choices: role of sodium intake
Sodium intake from processed and restaurant foods contributes to high rates of high blood pressure, heart attack, and stroke. According to the US Centres for Disease Control and Prevention, 500,000 deaths each year are related to high blood pressure; reducing sodium intake could prevent thousands of deaths annually.
To make packaged food tastier, FMCG companies add a lot of salt. Moreover, excessive salt is also used as a preservative. “The intake of salt has increased significantly higher than what we normally would like to have and it is now exceeding the body’s actual need,” voiced Dr Gupta.
Rising high blood pressure cases among high school children
Several studies have astonishingly pointed out increasing instances of high blood pressure among high school students. Calling it a bad trend, Dr Gupta raised concern about younger students from high school reportedly complaining about high blood pressure. “Once in a week or two, younger students from senior secondary classes are found to have reportedly complained about high blood pressure. In the aftermath of COVID, we are seeing students excessively glued to smartphones and laptops. Increased screen time may lead to decreased melatonin secretion, resulting in poor sleep hygiene. In addition to digital distractions, students are also under a lot of pressure. Therefore, we are also observing that people who are younger are also developing heart diseases.”
Risks of undetected hypertension
“People have a myth that hypertensive means one is tense and hyper in interactions and thoughts. But it’s never the case, and most often, patients tend to be asymptomatic. Now, if the blood pressure remains high for sufficient time and is untreated, the fear of complications arises,” said Dr Praveen Kulkarni, Senior Consultant-Cardiologist, Global Hospitals, Parel, Mumbai.
High blood pressure is also infamously called the “silent killer” because most people don’t have symptoms. If left untreated, it can impact four major organs: the heart, kidney, brain, and eyes. In the case of the heart, it can lead to heart failure, weakness in the heart, or blockages in the arteries. It can also lead to kidney failure and stroke, and patients with hypertension can also lose vision because of hypertensive retinopathy.
Gaps in public health system that need to be addressed for timely intervention
Experts have called for school-level monitoring for high BP. As per the international guidelines, people should monitor their blood pressure from the age of 20 years, which includes the entire cardiac risk profile, including blood pressure, cholesterol, blood sugar, et cetera. “Students from high school onwards should get their health checkups done and be monitored regularly, and it should be mandatory. Plus, there should be regulations about the salt content of all the foods we are eating. More awareness among people for better choices will lead to better outcomes,” said Dr Gupta.
More than half of the hypertensive population is unaware of their condition. Among the ones who are hypertensive, more than half are not adequately treated. Dr Kulkarni underscores that not only do we lack in diagnosing hypertension, but the need of the hour is to highlight that treatment of hypertension is not based on the symptom but on reading. “Many times, patients who seem to be asymptomatic tend to stop their medications on their own. There should be awareness that blood pressure treatment is to be monitored, and any changes in medication have to be on the advice of a qualified doctor,” concluded Dr Kulkarni.
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