Hypertension – The Silent Killer

“Death, so called, is a thing which makes men weep, and yet a third of life is passed in sleep.” ― George Gordon Byron.

Hypertension, a monster, is like an iceberg- only the tip is seen. Hypertension classically follows the rule of halves – only half of the population is aware of its existence in them, only half of those who know that they are hypertensive take treatment & only half of those who take treatment are adequately treated. This scenario is of the developed world, in developing world situation is grim.

An interesting fact that is worth considering is the tracking of blood pressure. Children when followed in their adulthood with respect to their blood pressure were found to follow the “track” of having low B.P. will tend to remain low & high levels tend to remain high as one age. This information can be used to identify the individuals who are likely to develop hypertension later in life.

Risk factors that can make an individual hypertensive are many – male gender, diabetes, obesity, increased salt and fat intake, high alcohol consumption, sedentary life style (the risk of hypertension is 1.39 times (1.24- 1.56) higher among sedentary workers as compared to moderate or heavy workers), stress, low intake of dietary fibers, family history of hypertension.

The level of hypertension in our society can be judged from the fact that in one study done in Rohtak (urban areas) almost 60% of adults were hypertensive & in rural areas 35% were hypertensive. The high prevalence of hypertension among young adults is an indication for the healthcare providers and policy makers to implement educational and preventive strategies to reduce the burden of hypertension in the society. High prevalence of hypertension among elderly population is a serious concern and it is an independent risk factor for cardiovascular diseases, heart attacks, heart failure, stroke, renal failure and peripheral vascular diseases.

The average Indian diet contains 15 grams of salt/day but the recommendation is less than 5 grams of salt/day (2gm of sodium). Studies have firmly shown that primitive societies used to consume less than 1.5gm of sodium a day and they were virtually free from hypertension.

Hypertension is a chronic disease but developed countries have shown, with the use of effective drugs, control of hypertension is feasible and studies have shown that it is possible even with the restricted resources we have.