Overview#
Hypertension, commonly known as high blood pressure, is a condition where the force of blood against artery walls is persistently too high (≥ 140/90 mmHg). It affects roughly 1 in 3 Indian adults, yet nearly half remain undiagnosed because it is largely asymptomatic. The ICMR-INDIAB study estimates over 315 million hypertensive adults in India. Untreated hypertension is the leading risk factor for heart attacks, strokes, and chronic kidney disease.
Causes & Risk Factors#
- Excessive salt intake – the average Indian consumes 10-11 g of salt daily, far above the WHO-recommended 5 g limit.
- Obesity and abdominal fat – BMI > 23 in Indians significantly raises risk.
- Family history – genetic predisposition accounts for up to 30-50 % of cases.
- Sedentary lifestyle – lack of regular physical activity stiffens arteries over time.
- Chronic stress and poor sleep – elevate cortisol and adrenaline levels, raising BP.
Signs & Symptoms#
- Often called the "silent killer" – most people have no symptoms
- Headaches, particularly at the back of the head in the morning
- Dizziness or lightheadedness
- Blurred or double vision
- Nosebleeds (in severe cases)
- Shortness of breath during mild exertion
- Palpitations or chest discomfort
- Fatigue and confusion (in hypertensive emergencies)
Diagnosis#
Blood pressure should be measured on at least two separate occasions before diagnosis:
- Clinic BP measurement – systolic ≥ 140 or diastolic ≥ 90 mmHg confirms hypertension.
- Ambulatory Blood Pressure Monitoring (ABPM) – 24-hour average ≥ 130/80 mmHg.
- Blood tests to assess organ damage: Kidney Function Test, Lipid Profile, Blood Sugar.
- ECG and Echocardiogram – to check for left ventricular hypertrophy.
Treatment Options#
Medications: ACE inhibitors (enalapril, ramipril), ARBs (telmisartan, losartan), calcium channel blockers (amlodipine), and diuretics are first-line options. Most Indian guidelines recommend starting two drugs at low doses for Stage 2 hypertension.
Lifestyle modifications:
- Reduce salt to < 5 g/day – avoid pickles (achaar), papad, processed foods, and packaged namkeens.
- Follow the DASH diet adapted for Indian cuisine: increase fruits, vegetables, low-fat dairy, and whole grains.
- Engage in 30-40 minutes of brisk walking or cycling at least 5 days per week.
- Limit alcohol and quit smoking entirely.
Prevention#
- Monitor your blood pressure at home if you have a family history – digital BP monitors are affordable and widely available.
- Reduce sodium by using less salt while cooking and avoiding table salt.
- Maintain a healthy weight through regular exercise and a balanced Indian diet.
- Practice stress-management techniques like yoga, meditation, or deep breathing.
- Get at least 7-8 hours of quality sleep every night.
When to See a Doctor#
Consult a doctor if your BP reading is consistently above 130/85 mmHg at home. Seek emergency care for readings above 180/120 mmHg, sudden severe headache, chest pain, vision changes, difficulty speaking, or numbness on one side of the body – these may indicate a hypertensive crisis or stroke.