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Too young for high BP and subsequent heart attack? Not really

High blood pressure is showing up among Indians in their 20s and 30s, and it’s becoming a gateway to cardiac conditions and heart attacks

health-and-fitness Updated: Sep 27, 2015, 13:49 IST
Rhythma Kaul & Antara Sengupta
Rhythma Kaul & Antara Sengupta
Hindustan Times

Shekar* was 29 when he had his heart attack.

The then BPO operations executive woke up one afternoon with severe chest pain and breathlessness, and was perspiring heavily.

Thinking it was acidity, he downed some syrup. When the pain just wouldn’t subside, he visited a hospital, where doctors found that his blood pressure was 180/100 mmHg, way above the normal of 140/90 mmHg.

An ECG revealed that he had suffered a heart attack. “I was shocked,” Shekar says.

The next day, he headed to a super-specialty hospital in Mumbai and consulted with cardiovascular and thoracic surgeon Dr Pavan Kumar.

“When I questioned him about his lifestyle, it turned out that he smoked and drank excessively, and worked erratic and night shifts,” says Dr Kumar. “These were major contributors to his condition.”

He had probably had the high blood pressure for a while and ignored it, raising his chances of a heart attack. He is not alone.

On Friday, the Cardiological Society of India conducted a survey that covered 1.8 lakh people across 24 Indian states, measuring BP at railway stations, bus stops, malls etc.

The initial results showed one in three adults suffered from high blood pressure or hypertension.

About two-thirds of them had no idea they had the condition; 25% of those surveyed were aged 31 to 45.

With blood pressure increasingly becoming a gateway to cardiac disease - even among those in their 20s and 30s - doctors warn that no symptom should be ignored.

High blood pressure patient Bhajan Pandita has modified his lifestyle to include more sleep, regular meal times, a healthier diet and the occasional morning walk. Coupled with medication, this has brought his blood pressure down to a normal 130/90 mmHg, though he still struggles to make time to exercise. (HT Photo/ Raj K Raj)

“One should start being screened for high BP at 20, especially if there is a family history of heart disease, and then periodically every six months to track the pattern,” says Dr S. Ramakrishnan of the All India Institute of Medical Sciences’ department of cardiology. “Often, a heavy head is a sign of high blood pressure. Even such a mild sign should be investigated, because high BP is a silent killer that can damage kidneys, cause blindness, lead to heart attack and brain stroke.”

For Shekar, the attack served as a wake-up call. He has since quit his job and moved to the real-estate industry, where he has a less stressful job and regular work hours.

Two years on, he is early to bed and early to rise, exercises and does yoga for an hour every morning, and has breakfast and lunch on time. He also goes for a 15-minute walk after dinner.

“I avoid junk food as much as possible and have quit smoking and drinking as well,” Shekar adds. “And the results are very heartening - my BP levels are normal at 120/80, and my heart is stable.”

He also knows that he must see a doctor at the slightest sign of trouble.

Silent killer

Risk factors for high blood pressure and heart disease are kicking in earlier and

earlier, as a result of junk food in school-going children’s diets and low activity levels among teens who are spending more time indoors and online.

By the time people enter their 20s, this combination of poor lifestyle and diet put them at risk for high BP and cholesterol - conditions earlier seen almost exclusively in those over 50.

“The stress, in fact, should be on pre-hypertension rather than hypertension or high blood pressure,” says Dr Tilak Suvarna, senior interventional cardiologist at Asian Heart Institute, Mumbai. “Over the past 20 years, multiple long-term studies have shown that blood pressures higher than 120/80 are linked with an increased risk of heart disease and stroke. That’s why we now have the term pre-hypertension. It describes people with blood pressures between 120/80 and 139/89. Young adults with even slightly above-normal blood pressure are more likely to have heart problems later in life.”

The latest studies in fact indicate that the normal of 140/90 mmHg needs to be lowered, adds Dr Ashok Seth, chairman of cardiac sciences at Fortis Escorts Heart Institute, Delhi.

“To find that hypertension is not of a disease of the old anymore is of great concern as it means early onset of heart disease,” Dr Sheth adds.

So it was with Mumbai businessman Piyush Shah, 34, who suffered a heart attack that was traced back to high blood pressure caused by an unhealthy lifestyle.

“The reports took me by surprise as I had no history of heart ailment,” says Shah. “My doctor explained that, due to my business, I was eating at odd hours, bingeing on junk food such as chips, burgers and rolls, and skipping meals. I was also getting no exercise.”

Shah now eats lots of fruits and vegetables and has healthy meals at regular intervals. He also sleeps early, wakes early, and goes for a walk every morning.

His BP is now a normal 110/75 and his ECG graphs are normal too.

Bhajan Pandita, meanwhile, has been battling high blood pressure for four years.

“The doctor confirmed what I already suspected - that my lifestyle was at fault,” says Pandita, who, ironically, works in the management division of a Delhi hospital. “I would eat dinner around midnight, sleep at 1, wake at 6. I’d usually skip lunch or eat it as late as 5 pm. There was no time to exercise because of my long work hours.”

The 34-year-old has now modified his lifestyle to include more sleep, regular meal times, a healthier diet and the occasional morning walk.

Coupled with medication, this has brought his blood pressure down to a normal 130/90 mmHg, though he still struggles to make time to exercise.

(* Last name withheld on request)

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