Hypertension: What's your number?

  • Sanchita Sharma, Hindustan Times, New Delhi
  • Updated: May 09, 2015 18:57 IST

Have a mild, unexplained headache? You could pop a painkiller and forget all about it. Or you could decide to play doctor and run through a rapid "headache symptoms checklist" to diagnose the mysterious cause.

Be prepared for your pain to worsen. A headache is a symptom, a sign that all is not well, and it can be triggered by problems ranging from simple stress to dehydration, exhaustion, eyestrain, infections and high blood pressure.

If you're not stressed and don't have accompanying signs of illness -- fever, body ache, cough, cold, nausea, tummy trouble etc -- the cause is very likely to be high blood pressure, which is called hypertension when lasts for more than a few weeks.

Apart from heart disease, hypertension raises the risk of stroke, heart failure, kidney damage, blindness and dementia. The lowering of the risk bar puts over half of urban India's adult population at risk. The risk of disease and death doubles with each 20-point rise in the top number (systolic pressure measured when the heart pumps blood into arteries), or a 10-point rise in the bottom number (diastolic pressure measured when the heart's getting refilled with blood between beats).

Keep it low
Several studies over the past decade show that the risk of heart disease begins at blood pressures lower than previously thought. Normal blood pressure would be 120 /80 mmHg or lower, and as long as you don't feel faint or dizzy, the lower it is, the better is it for your health. For example, people who are lean and very active often have blood pressures of 110/70 mmHg.

Blood pressure nearly always rises with advancing age as body fat increases, activity declines and arteries become stiff and narrowed by accumulating plaque.

Crossing the "normal" reading of 120/80 mmHg spells trouble, with readings from 120/80 mmHg up to 139/89 mmHg being classified prehypertensive. Readings from 140/90 mmHg to 159/99 mmHg is stage-1 hypertension and anything over 160/100 mmHg is stage-2. Both conditions need to be treated and controlled aggressively using drugs.


Normal blood pressure would be 120 /80 mmHg or lower, and as long as you don't feel faint or dizzy, the lower it is, the better is it for your health. (Shutterstock)

About 27-32% people in urban India are hypertensives with blood pressures over 140/90 mmHg. Over a third of them don't even know they have high blood pressure that needs treatment, while more than half of those on treatment for it don't have it under control.

In most cases, hypertension does not cause symptoms. And in rare cases when symptoms- headaches, ringing in the ears, lightheadedness, sleeplessness, fatigue - do occur, people put it down to stress and overwork and don't seek treatment.

Hidden signs
The only way to know if your blood pressure is normal is to have it measured. The test takes a minute, is cheap, noninvasive and painless. It should be a part of a routine check-up and all doctors should do it free during a medical visit, irrespective of what you're consulting them for.

While both stages of hypertension need immediate attention, pre-hypertension can be treated with raising physical activity (walking at least 10,000 steps a day), losing excess weight, having a low-salt diet (5 gm salt a day, or 2 gm sodium), limiting alcohol to two units (60 ml) a day and quitting smoking. All those factors increase blood pressure. Cutting back on salt intake to less than 5 gm a day (one level teaspoon) lobe cuts heart disease risk by 25% over the next decade. Exercise is the next most effective intervention.

Raging hypertension is not something exclusive to adults. An increasingly number of children - especially teens - are being diagnosed with hypertension, which indicates that life-altering health choices need to be made from a young age.

One in 15 (6.4%) students in public and government schools in Delhi have high blood pressure, found a survey of 1,022 student ages 13 to 18 reported in the Archives of Disease in Childhood, a British Medical Journal publication. The study found that strongest predictors of high blood pressure in teens were belly fat (high waist sizes), high triglycerides (blood fats) and a family predisposition to hypertension. Compared to adults, teens and young adults can easily reverse the problem without medicines by becoming more active, eating healthy and losing weight.

So, instead of wasting time stressing over what's making your blood pressure shoot skywards, focus on things you can do to lower it. And if it is things you can do together as a family, you can look forward to a big reduction in your medical bills in the near future.

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