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High Blood Pressure - easy to control, dangerous to ignore

Hypertension is a condition where the pressure in the blood vessels becomes too high. According to the World Health Organisation (WHO), around 1.28 billion adults, world-wide, have hypertension. Several studies point to a significant increase in the incidence of hypertension in children, which is all the more concerning.  

Many of those having hypertension are unaware that they have the condition, says WHO. There are rarely any symptoms and it is mostly diagnosed only when one consults a doctor for other illnesses. If left untreated, it could get serious and cause other health problems like heart ailments, kidney disease and stroke. In fact, hypertension is considered to be a major cause for premature death across the globe. 

WHO has set a target of reducing the prevalence of hypertension by 33% between 2010 and 2030. The Indian government’s “75/25” initiative aims to screen and provide standard care for 75 million individuals with hypertension and diabetes by 2025. Tamil Nadu state has introduced the “Makkalai thedi maruthuvam” scheme for screening and treatment of hypertension at the doorstep. 

What do blood pressure numbers mean? 

Blood pressure is recorded as two numbers:

  • Systolic blood pressure (the first number) – indicates how much pressure blood is exerting against the artery walls when the heart contracts.
  • Diastolic blood pressure (the second number) – indicates how much pressure blood is exerting against the artery walls while the heart muscle is resting between contractions.

Blood pressure numbers of 120/80 millimeters of Mercury (mm/Hg) or less are considered to be within the normal range. If the numbers are consistently above this, in the range of 130- 140 systolic and 90 -100 diastolic, or more, a person is said to have hypertension. 

Causes for hypertension

Factors that increase the risk of hypertension are old age, heredity, obesity, sedentary lifestyle, increased salt intake, smoking and drinking. While old age and hereditary factors may not entirely be  in our control, the rest can be managed well if we recognize the seriousness of the issue and take the extra effort to keep our blood pressure at normal levels. 

  1. Obesity: A recent Lancet study reveals that 44 million women and 26 million men, aged above 20, are obese in India; and, 12.5 million children – 7.3 million boys and 5.2 million girls – aged between 5 and 19 were found to be grossly overweight. There has been a steep increase in the numbers over the years. Changes in diet  and lack of exercise are two major contributors for obesity. Our eating habits have changed drastically over the years. With the cropping up of several restaurants and eateries in every corner of the country on the one hand, and the increased availability of a variety of ultra-processed foods on the other, many of us, especially the youth, are consuming more of these unhealthy foods than  home cooked, traditional foods. Several reasons could be attributed to this – the sheer availability, enhanced taste, convenience, ease of preparation, and so on. These foods are often high in salt, sugar and/or fat (HFSS). HFSS foods are known to be  major contributors in the incidence of  non-communicable diseases. 
  2. Sedentary lifestyle: Our addiction to the digital world has become such that children rarely go out and play. Everything is confined to mobile phones and laptops. They spend more time sitting with their devices than standing or walking. This is also one of the main reasons for obesity at a young age. Adults are not doing any better as our  work culture has become such that people spend more time in front of computers. They sit in one position for long periods without even realising it. Later, they unwind in front of the TV or with their phone before going to sleep. Added to this is our constantly reducing green spaces, leading to obesity at all ages. There is no physical exercise and such sedentary behaviour could lead to serious health conditions that can have long term impacts to a person’s physical and mental well-being. 
  3. Increased salt-intake: Consumption of food high in salt (sodium) is one of the major causes for high blood pressure, obesity, gastric ulcer, and cardiovascular and kidney diseases. WHO states that globally, consumption of salt is too high and around 1.89 million deaths every year is associated with increased intake of salt. WHO recommends no more than 5 grams of salt a day. That’s just one teaspoon! Many of us don’t realise that salt is hidden in many common foods like bread and sauces. The Indian diet is especially high in salt with an IndiaSpend analysis finding the average Indian to consume 10.98 grams of salt a day. That is 118% higher than the WHO recommended salt intake amounts!
  4. Smoking and drinking: Consumption of tobacco and overconsumption of alcohol are known factors that increase blood pressure.  

Prevention and Control of hypertension

Lifestyle changes are the first line of defense in preventing and managing hypertension. These include,  

  • Dietary Adjustments: Reducing salt intake, increasing consumption of fruits and vegetables, and limiting high salt, fat and sugar foods are crucial. 
  • Physical Activity: Regular exercise helps lower blood pressure. It's recommended that young individuals engage in moderate to vigorous physical activities
  • Weight Management: Maintaining a healthy weight is important, as obesity is a significant risk factor for hypertension
  • Avoidance of Tobacco and Alcohol: Avoiding the consumption of tobacco and alcohol can significantly reduce blood pressure
  • Pharmacological treatments: Once diagnosed, and when lifestyle modifications are insufficient to control hypertension, medication may be necessary. The choice of medication can depend on several factors including age, the severity of hypertension, and other underlying health conditions. Consulting the doctor regularly for hypertension management is crucial. 
  • Periodical screening for hypertension beyond the age of 20 is essential for better care and control of the condition. 

World Hypertension Day and Salt Awareness Week

World Hypertension Day is observed on May 17, with the theme for this year being “Measure your blood pressure accurately, control it, live longer”.

Salt Awareness Week is observed from May 13 to May 19, with the theme for the year being “It’s time to shine the spotlight on salt”, highlighting the issue of “hidden” salt in many processed and ultra-processed foods. Some countries are making it easier to avoid high-sodium food, by requiring clear warning labels on the front of unhealthy products, so that consumers are able to make informed choices. India also needs a similar regulation that would help in controlling the threat of non-communicable diseases, particularly cardiovascular diseases.

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