High Blood Pressure: Risks Of Hypertension, And Ways To Manage It

Hypertension triggers initially include headaches, dizziness, blurred vision, nosebleeds, shortness of breath, chest pain, fatigue, or confusion.

By Dr Shraddha Bhure

India has been grappling with a growing burden of hypertension for decades now. Among the 1.3 billion people affected globally, India alone has an estimated 220 million adults suffering from hypertension. Despite this, many remain unaware of their condition. A recent study by the Indian Council of Medical Research (ICMR) revealed that nearly three out of ten people in India, aged between 18 and 54 years, have never had their blood pressure measured. Therefore, it becomes crucial to address this issue by recognising the symptoms, the risk factors, and adopting a holistic approach to managing hypertension and its associated complications.

Blood pressure refers to the pressure exerted by blood as it is circulated throughout the body by the heart. When this pressure remains persistently elevated, it leads to hypertension (commonly known as high blood pressure), which places additional strain on the heart and blood vessels. Typically, normal blood pressure falls below 120/80 mmHg, whereas hypertension is diagnosed when blood pressure consistently measures 130/80 mmHg or higher.

Risks of hypertension

Hypertension does not present noticeable symptoms, until it reaches dangerously high levels. Initial triggers of the condition include headaches, dizziness, blurred vision, nosebleeds, shortness of breath, chest pain, fatigue, or confusion. As these are often considered to be symptoms for common illnesses, it increases the chances of undiagnosed hypertension, resulting in deterioration of heart health, kidney ailments, and metabolic disorders.

One of the significant contributors to hypertension is diabetes. The I-CaRe for Diabetes survey states that seven out of every 10 individuals with type-2 diabetes have coexisting hypertension.  High blood sugar levels narrow the blood vessels throughout the body, prompting the heart to pump harder, consequently leading to hypertension. This can also potentially damage the kidneys by applying excessive pressure on the glomeruli, a channel of blood vessels, responsible for filtering waste and excess fluids from the blood, thereby leading to reduced kidney function.

Long standing hypertension can also lead to pressure overload in heart chambers which is a primary reason for heart failure. It is a set of manifestations caused by the failure of the heart's function when the heart muscle doesn't pump blood as well as it should. According to a 2020 community-based study, it was demonstrated that hypertension may contribute to the development of heart failure in as many as 50-60% of patients.

This interplay is known as cardio-renal-metabolic (CRM) disease, recognised as one of the most disruptive public health issues of the current century. It involves complex interactions between metabolic diseases such as type 2 diabetes (T2D), various types of cardiovascular disease (CVD), and chronic kidney disease (CKD).

These interconnected conditions are often fatal, with one in three people living with two or more of these chronic illnesses. These conditions make up four of the top 10 global causes of death, as reported by the World Health Organization (WHO).

How to manage hypertension

Contrary to popular belief that genetics play a major role in one developing hypertension, lifestyle is a prominent risk factor. This condition, therefore, can be effectively managed and controlled through various lifestyle changes and medical interventions. Here are some recommendations.

1. Regular Blood Pressure Monitoring: Regularly monitor blood pressure at home or during routine healthcare appointments. This aids in tracking progress, detecting any variations and ensuring that blood pressure stays within the target range. Maintain regular communication with healthcare professionals to discuss blood pressure management, adjust medications if needed, and address any queries.

2. Healthy Diet: Adopt a balanced and heart-healthy diet that includes reducing sodium intake, and consuming more fruits, vegetables, whole grains, lean proteins, and low-fat dairy products. The Dietary Approaches to Stop Hypertension (DASH) diet is often recommended for individuals with hypertension.  

3. Regular Exercise and Weight Management: Engage in regular aerobic exercises such as brisk walking, jogging, swimming, or cycling. These exercises also contribute to weight management. Even a small reduction in weight can have a positive impact on blood pressure.

4. Limit Alcohol Consumption and Avoid Smoking: Both alcohol consumption and smoking can elevate blood pressure and heighten the risk of cardiovascular diseases. Hence it is advisable to limit the alcohol consumption to moderate levels and abstain from smoking entirely. 

5. Stress Management: Adopt stress-relieving practices such as meditation, deep breathing exercises, yoga, or engaging in hobbies to effectively cope with stress.

India’s continuous struggle with increasing cases of hypertension, exacerbated by widespread unawareness, underscores the importance of recognising the interconnected risks such as cardio-renal metabolic disease and embracing a holistic approach to manage and tackle this condition. 

(The author is the Medical Director of Boehringer Ingelheim).

[Disclaimer: Information provided in this article is for general guidance only. Individual results may vary. It is important to consult a healthcare professional, who knows your body type and medical history, before implementing the suggestions and information provided herein].