One in three Indians suffer from prehypertension, as per the recent findings of Indian Council of Medical Research (ICMR). The study has raised concerns as it depicts that the young Indian population in their productive age group are at the cusp of developing hypertension, the harbinger of other non-communicable diseases, especially cardiovascular diseases.
The recent study on District-Wise Heterogeneity in Blood Pressure Measurements, Prehypertension, Raised Blood Pressure, and their Determinants Among Indians conducted by Indian Council of Medical Research shows that more than 33 percent of Indians suffer from prehypertension.
Hypertension, also known as high blood pressure, is a condition where blood pressure in the blood vessels is too high. “Usually for blood pressure, the normal range for systolic pressure is 120 mmHg to 130 mmHg, and diastolic pressure is less than 80 mmHg. If someone’s blood pressure readings are borderline, they are considered to have prehypertension,” says Dr Chirag D, consultant-Interventional Cardiology, Aster Whitefield hospital, Bangalore.
Hypertension can cause heart issues, kidney complications and other health issues if left untreated. Prehypertension, the phase of elevated blood pressure, while not yet classified as hypertension, presents a critical window for intervention, giving one more time to avoid the progression to diabetes. It serves as both a warning and opportunity to stave off a host of cardiovascular diseases that could follow.
1 in 3 Indians suffer from prehypertension
The study collected data from the National Family Health Survey (NFHS-5) on 743,067 persons between the ages of 18 and 54.
“Prehypertension affected 33.7% of the population, with varying prevalence across districts. Raised blood pressure was there in 15.9%, with notably higher rates in the southern region (16.8%). Determinants included age, gender, education, wealth, lifestyle, obesity, and blood glucose levels,” the analysis said.
There were 12.4% men and 87.6% women across 707 districts in 28 Indian states and eight Union territories. “The National Family Health Survey −5 (2019–21) reported that 21% of women and 24% of men aged 15 and over have hypertension and 39% of women and 49% of men have pre-hypertension,” the study says, pointing out that the prevalence of prehypertension was more in men than women. However, as also mentioned in the analysis, NFHS-5 sampled more women than men to cover more maternal and child health indicators.
Dr Srinivas Prasad, senior consultant, interventional cardiology, Fortis Hospital, Bangalore, says hypertension is more common in males, especially when they are between the age of 35 to 45. He highlighted that the analysis was based on a skewed sample size which had nearly 88 % of the women. “That’s one of the reasons why the study depicts less prevalence of prehypertension in women compared to men, as it is given that they are already at a lesser risk of hypertension,” said Dr Prasad.
The ICMR study key findings
- Individuals aged over 30 years had higher odds of being prehypertensive.
- Higher odds of prehypertension were observed in individuals from wealthier households and those overweight or obese
- Literacy generally lowered the odds of prehypertension.
- Marriage and urban residence were associated with lower odds in several places.
- Tobacco and alcohol consumption had varying effects, and obesity, particularly obesity/overweight, was consistently linked to higher odds.
- The average prevalence of prehypertension was 30.2 % in southern India
- The average prevalence of prehypertension was 39.4 % in northern India
- Among the total 347 districts that were surveyed, Bihar and Karnataka had the lowest rates of prehypertension in the top 20 districts, while Rajasthan and Jammu and Kashmir had the highest rates in the bottom 20 districts.
Agreeing with the study, Dr Prasad says, the regional differences do exist, and the prevalence rate of prehypertension. can change across regions, influenced by the dietary pattern and the lifestyle pattern. In Bangalore, the approximate prevalence rate is around 15 to 20%, while in certain areas of Delhi or Uttar Pradesh, the incidence rate is probably 1 in 3, due to their dietary habit.
The risk of hypertension for those with prehypertension
Dr Chirag says that those with prehypertension should be aware of the risks of hypertension, so if treated in the early stages, it is possible to prevent progression towards hypertension. “Hypertension can also lead to secondary problems like heart dysfunction, or kidney related issues. So if monitored early, the related effects of hypertension can be avoided,” he said.
The initial symptoms of hypertension include headache or tiredness. Dr Prasad adds that apart from this, certain factors such as sedentary lifestyle, consuming excessive salt, intermittent fasting, can also increase the risk of having hypertension. If they have other risk factors like obesity or diabetes, or if they have a history of smoking, they can progress to hypertension.
“The main aim of the treatment for prehypertension is to stop the progression to hypertension. It is important to make lifestyle modifications and lead a healthy lifestyle,” Dr Chirag added.
Halting progression towards hypertension
Experts explain that typically, the transition period from prehypertension to hypertension varies somewhere between six months to four years. However, with healthy lifestyle modifications one can delay it by at least five to 10 years.
If one’s genetic makeup is good, and s/he has modified their lifestyle, there are lower chances of developing hypertension. If one has prehypertension, s/he must focus on their diet, regularly exercise, avoid stress, meditate, and follow a regular sleep schedule. “The most important factor is to moderate the intake of salt, avoid any processed foods as they contain high salt content. It is also important to avoid food substitutes like papad, pickle, etc. One must exercise depending on individual ability. At least 30-45 minutes of brisk walking should be done daily, for five days in a week,” says Dr Chirag.
Hypertension is known to have genetic predisposition even if one leads a healthy lifestyle. The only way to know is to keep monitoring blood pressure and take corrective measures. “These lifestyle modifications can ensure that the pre-hypertension can be reversed to normal, or if not normal, at least it will remain in that state so that they don’t go into the hypertension stage,” concludes Dr Prasad.
Takeaways
- A study by the Indian Council of Medical Research has shed light on the pervasive nature of prehypertension among the Indian population.
- If someone’s blood pressure readings are borderline, they are considered to have prehypertension.
- One can stop the progression of prehypertension to hypertension by maintaining a healthy lifestyle.
- It is important to reduce the intake of salt and regularly exercise.
- Good genetic makeup and lifestyle modifications help lower chances of developing hypertension.
