Girish Mirchandani, 36, a branch manager at a private bank, was diagnosed with hypertension two years ago. Hypertension, simply put, is high blood pressure (HBP). Blood pressure in the arteries increases, making the heart work harder for blood circulation.
HBP is the leading cause of strokes and a major risk factor for heart attacks. If steps are not taken to lower the blood pressure, it can damage the blood vessels, heart, kidneys, eyes, and other organs.
Mirchandani has a high-stress job, an active social life, smokes regularly, and has little time and energy for diet or exercise. Doctors fear he represents many of today's working professionals in the city. He is also part of a growing tribe that is contracting lifestyle diseases or chronic ailments such as hypertension, diabetes and cholesterol in their 30s.
An HT-C fore survey among general practitioners in Mumbai (see box on top), revealed that 75% of patients with any of these diseases were less than 40 years old. The survey revealed that hypertension is the lifestyle ailment males in Mumbaiites complain about the most.Doctors said the only way to effectively manage these chronic ailments is a combination of drug therapy, lifestyle modification, and regular health checks.
"These days no one can avoid work pressures and every job has targets. I had been smoking for more than 10 years and had an erratic life," said Mirchandani, who was put on medication two years ago. "I completed a 16-week diet course and have joined a gymnasium," he said. Mirchandani confesses that he now watches his diet six days a week and has cut down on smoking.
Hypertension or high blood pressure is often not detected because of lack of symptoms. It is usually detected only when complications such as cardiac or kidney problems surface. According to doctors, two-thirds of Indians over 60 are at risk of contracting hypertension. Although some are genetically predisposed, stress has been identified as one of the major precipitating factors, apart from irregular eating habits with high salt intake, obesity and lack of exercise.
Less than 5% of HBP patients contract hypertension due to secondary ailments such as side effects of medication - including steroids, chronic kidney disorders, post-pregnancy and adrenal gland disorders.
Mirchandani had been suffering from headaches for some time before his HBP was detected during a corporate executive health check up. He also has a family history of diabetes.
"We are getting patients in their 20s too. Most youngsters today have a hectic social life, high-stress jobs, insufficient sleep and irregular food habits. The biggest challenge is that they are coming to us only at the stage of some complication or acute problems," said Dr G Manoj, consulting cardiologist.
"The problem is worsening because people do not go to family doctors. Family doctors know the patients' history and can diagnose and counsel them. Now people go directly to specialists, who may not be able to treat holistically, because there is lack of patient-doctor rapport." said Dr S D Jain, Raheja Hospital.
Doctors also said many people are unable to adhere to a disciplined lifestyle. "Control is poor. People take medication but do not follow lifestyle changes. Also they have misconceptions, for instance, that only diastolic is important and not systolic, which is detrimental," said Dr Akshay Mehta. (See box: What is hypertension?)
"People get into a vicious cycle because of modern lifestyles, where they acquire many luxuries on loans, cannot cut down on consumption and the stress goes on increasing. You must know your capacity to work because later it becomes difficult to make adjustments in jobs," said Dr Hasmukh Rawat, a cardiologist with Fortis Hospital.
Another cause for concern is side effects of lifelong medication. When a patient starts medication in his 30s and 40s, within the next 10 to 15 years it may start having adverse effects, which include low sexual drive, resistance and other complications. However, doctors said side effects rarely get documented because a patient often develops other chronic ailments after a few years.
"The disease has to be managed both ways. Doctors have to become counsellors and patients have to be cautious. Anti-anxiety and sleeping pills only suppress the stress, do not cure it. So keeping a positive approach is the only thing that can go a long way in management of this lifelong condition," said Dr Jain.
"One should take it as a part of life, not worry"
Hemantt Upasini, 48
Hemantt Upasini, 48, cannot remember a time when he did not have to travel for work. A marketing professional for 25 years, he is on tour for as many as 15 to 20 days a month across Maharashtra and south India. As if this work schedule was not bad enough, he would travel specially to different well-known joints in Mumbai to eat his favourite vada pao.
He was not surprised when he was diagnosed with high blood pressure, seven or eight years ago. "I had acidity. My schedule was so erratic that I would sometimes get up 2 am to catch a 5 am flight, work the whole day, and then binge at night. In the marketing field, you really cannot avoid any of this," said Upasini, who works at Santacruz and still has to put in a week of travel every two months.
Now on medication, he has completely stopped eating junk food. "I used to have seven to ten cups of tea and regularly munch on chips, samosas and vadas at work. Now I have stopped completely and also switched to fresh fruit juices," said Upasini. He said he has also started walking regularly. "I don't worry about going to a park. I just walk near my house for 45 to 50 minutes at least five times a week."
He said the key is to not worry about the disease.
"You start experiencing the benefits of a good lifestyle such as undisturbed sleep, no acidity and lighter feeling. It is easy to do and one should take it as part of life."
"No medicines, I rely on discipline, will power'
Nita Advani, 41
A mother of two boys, 41-year-old Nita Advani has her hands full with the children's homework, extracurricular activities in school, household chores and looking after her husband.
Diagnosed with high blood pressure after pregnancy, the Mulund resident is determined to keep it under control with lifestyle changes and not go on medication.
In keeping with everyone's routines, she is not able to go to bed before 2 am every day. Although she cannot control her sleep schedule, she controls her diet. "We eat a very light dinner and stick to soups and salads. I avoid junk," Advani said.
Being active and having strong will power is the key to controlling HBP, believes Advani. "I don't think of it as a problem. I do everything that is needed for the family and at the same time try to exercise by walking for all my errands. Will power works the best," said the homemaker, who said her husband's cooperation has also helped her to cope. "My elder son is 17. He is independent and things will get easier. As long as I can avoid medicines, I will," she said,adding that she regularly keeps in touch with her doctor and takes his advice.
"Most people need medication because they are not prepared to or are unable to make so many disciplinary changes. But it is ideal if people can postpone the start of medication," said Dr G Manoj, Advani's doctor.