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Taming the Silent Killer

Aarti Aarti
02 Oct 2023

As only about 12 percent people with hypertension in India have their blood pressure under control, there is no alternative to adopting a healthy lifestyle.

Last week the 23-year-old daughter of a family friend, working for an overseas employer from home, had to be rushed for medical support after she complained of severe headache. Basic tests pointed out she was suffering from high blood pressure or hypertension. The consulting doctor explained that she was probably stressed, anxious and apprehensive about some bad outcome related to her work. Since she was feeling restless and had difficulty in concentrating, the doctor advised her to take rest for about a week. 

The case above is not an isolated one. Studies have shown that over the past few years with drastic changes in work culture a large number of employed people seem to be quite stressed and suffer from sleeplessness. They work for extended hours to fulfil targets, tend to regularly eat outside food that is high in sugar, salt and fat. They don’t have time to follow a healthy diet. Their targets have increased and they work for longer hours, usually during nights, which cause lack of sleep. They don’t have time to exercise or follow a healthy diet. Lack of sleep causes hormonal imbalance, leading to obesity, which collectively trigger diabetes, hypertension and heart disease. 

Hypertension is also called “the silent killer” because there are no symptoms, yet it is a major contributor to deaths from cardiovascular and kidney diseases and stroke. Uncontrolled blood pressure is one of the main risk factors for cardiovascular diseases such as heart attacks and stroke which are responsible for one-third of total deaths in India. 

Well, it is shocking that a class 8 student (12 years old) in Gujarat and a class 9 (14 years old) reportedly died in Gujarat and Uttar Pradesh respectively last week after collapsing in the classroom due to suspected heart attacks.

This September 19, the World Health Organisation (WHO) released its first-ever report on the global impact of high blood pressure. The main takeaway is that nearly half of people with hypertension worldwide are currently unaware of their condition; more than three-quarters of adults with hypertension live in low-and middle-income countries. The WHO Report suggest that if hypertension is effectively treated it can prevent 76 million deaths, 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure between now and 2050.    

The cause for serious concern is that dietary habits among many Indians seem to be shifting towards popular categories of ultra-processed food (UPF) that mainly includes (i) chocolate and sugar confectionery, (ii) salty snacks, (iii) beverages, (iv) ready-made and convenience food and (v) breakfast cereals. In India according to reports, overall, this sector grew at a compound annual growth rate of 13.37 percent in retail sales value between 2011 and 2021.

Simply put, hypertension is the condition in which the force of the blood against the artery walls is too high. So, blood pressure above 140/90 is considered high blood pressure and it is considered severe when the pressure is above 180/120. In medical language, the blood pushing against one’s arteries is measured as systolic (the pressure one’s heart creates when it contracts and pushes blood out) and diastolic (the pressure when the heart relaxes and fills with blood). So, when blood pressure is high, it forces the heart to work harder, eventually weakening it and leading to heart failure.   

Although blurry or double vision, fatigue, headache, palpitations, nosebleeds, shortness of breath, nausea are signs of hypertension, many a time, high blood pressure does not show any symptoms and one can only know by measuring it. As high blood pressure thickens blood vessel walls, restricting blood flow, it increases the risk of blood clots. Consequently, the blood vessels get weakened, furthering the risk of rupture and internal bleeding. By restricting the blood flow to the brain, hypertension increases the risk of stroke and dementia. Overall, hypertension is a health hazard because it can lead to various other complications like kidney damage and many other health problems. 

The prevention, early detection and effective management of hypertension according to the WHO are among the most cost-effective interventions in health care and should be prioritised by countries as part of their national health benefit package offered at a primary care level. The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to 1. 

More recently, public health experts, consumer groups, etc. have urged the Union government to curb the rising consumption of high fat, sugar, salt, and ultra-processed foods (UPF). According to a report in The Hindu, new data obtained through the Poshan tracker has revealed that 43 lakh children under the age of five years — or 6 percent of all children tracked — are obese or overweight.  Notably, one of the major underlying factors behind the increasing consumption of junk foods is triggered by the food industry’s pervasive advertising and promotional techniques to increase sales.  As per a recent report of the Nutrition Advocacy in Public interest (NAPi), of the advertisements it examined, none provided information about the amount of sugar, salt, or saturated fat it contains as stipulated by the Consumer Protection Act 2019, for a food product. 

What’s the way forward?

Indian Hypertension Control Initiative, a centrally-sponsored scheme by the Government of India, aims to fast-track access to treatment services for over 220 million people who have hypertension. It has set a target of 25 percent relative reduction in the prevalence of hypertension by 2025.

Our health is in our hands and therefore actions undertaken in the right earnest at an individual level, can bring in rich health dividends.

Regular physical activity is a must as it has been found to promote many physiological responses that result in lowered risk of hypertension.

In maintaining a normal blood pressure, studies have shown that reducing sodium intake and consuming a diet with lots of fibre and fruit and vegetables high in potassium and nitrates can help.

There is a need to curb alcohol consumption as its regular intake has been found to be linked to a high incidence of hypertension, even when consumed at low to moderate levels.

Even as research on the impact of tobacco use on chronic high blood pressure levels is inconclusive, tobacco smoking and evidently exposure to second-hand smoke including smokeless tobacco can elevate blood pressure. 

So, simple lifestyle changes that include remaining physically active, consuming a healthy diet, quitting tobacco and alcohol can help immensely in managing or preventing hypertension. While individuals can measure one’s own blood pressure, an evaluation by a health professional is important for assessment of risk and associated conditions. And in controlling hypertension and preventing complications, it is important to take medications.

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