Some pressure to lower hypertension

We've all been told that hypertension runs in families but now we know exactly how it's transferred down generations. Sanchita Sharma writes.

We've all been told that hypertension (high blood pressure) runs in families but now we know exactly how it's transferred down generations. This week, scientists reported identifying 16 genes linked to hypertension, a finding that is expected to help develop new treatments.

Scientists from 24 countries analysed data from more than 2 lakh (200,000) people to identify 16 points on the genome linked to blood pressure, they reported the journals Nature and Nature Genetics. Each genetic variant was found in at least 5% of people across the world, with some people having more than one, which ups their predisposition to develop the disorder.

But more than the role of genes, what causes hypertension is being overweight, inactive and eating too much salty food.

Hypertension affects one in three adults in Indian metros, with prevalence in villages being at a lower 12-17%, reports the South Asian Journal of Preventive Cardiology. Since there are either no or very generalised symptoms that can be attributed to other causes – headaches, fatigue, ringing in the ears or lightheadedness – everyone over 20 years should get a blood pressure reading taken once a year, recommends Dr R. R. Kasliwal, Chairman Division of Clinical & Preventive Cardiology at Medanta. And twice a year, if someone in your family – parents or sibling – has hypertension. "Hypertension causes 57% of stroke deaths and 25% of all heart attack deaths but a quick, cheap and painless reading can identify and bring blood pressure down to a healthy 120/80 mmHg without medicines," says Kasliwal.

Risk begins early. Even people with borderline hypertension – blood pressures between 120-139 millimeters of mercury (mm Hg) systolic (the top number in a blood pressure reading) or 80-89 mm Hg diastolic (bottom number) blood pressure in the range – are 3.5 times more likely to have a heart attack and 1.7 times more likely to develop heart disease than people with healthy blood pressure. These findings prompted US experts to recommend borderline hypertensives to use medicines.

In India, cardiologist reserve medicines for hypertensives with diabetes, kidney disease or those with damaged heart, eyes or kidneys because of previous disease. Experts in India say the less aggressive combination of losing weight, cutting back on salt, quitting smoking and exercising – is enough to bring blood pressure back to normal.

Eating lots of fruits, vegetables, low-fat dairy products and small amounts of saturated fat (animal fat and oils that solidify), red meats and sugar not only lowers blood pressure, but also levels of blood vessel-blocking bad cholesterol (low density lipoprotein or LDL), total cholesterol and the amino-acid homocysteine, each of which is an independent risk factor for heart disease and stroke.

What also help are aerobic activities – where you get out of breath but can still complete a sentence without effort – such as brisk walking, running, swimming and cycling at least five days a week.

If these don't work, only then should blood pressure-lowering medicines such as ace-inhibitors be considered. For most people, controlling high systolic pressure is more difficult than controlling diastolic. In most cases, more than one medicine is needed for effective control.

Of course, the most permanent treatment is to live life a little healthier. The benefits are tremendous and far outweigh the effort.