Medical fraternity divided on lowering BP range for Indians

A debate is raging in the medical fraternity in India whether the country should adopt the new lower blood pressure (BP) range of 130/80 as suggested by the American Heart Association (AHA) recently to label a person’s condition as that of hypertension. At present, anything below 140/90 is considered normal and only slightly on higher side.

National Diabetes Obesity and Cholesterol Foundation president  Dr Anup Mishra feels that given the huge problem of high blood pressure in India, which is on increase in rural as well as in urban region, it is high time we too adopted the new tighter range as decided by the AHA.

“After conducting intensive studies for quite long time, for the first time since 2003 heart experts from America have revised the comprehensive guidelines for blood pressure and hypertension. We should follow the new range as high blood pressure is a huge problem here also. This is the burden prevalent in the urban and rural areas cutting across the States,” he said.

Dr Mishra was of the opinion that the lowering the BP range as per AHA guidelines will help patients to get better and early treatment.

Hypertension is a chronic medical condition and one of the most common life threatening non-communicable diseases (NCD). It is defined as a repeatedly elevated blood pressure, exceeding 140 over 90 mmHg - a systolic pressure above 140 with a diastolic pressure above 90, according to health experts.

With the rise of urbanisation, there is increase in sedentary lifestyles, tobacco smoking, lack of physical activity, unhealthy diet intake, harmful use of alcohol etc., which are the risk factors for hypertension. Recent studies have reported that hypertension is present in 25-30 per cent urban and 10-20 per cent rural people in India.

This translates into an approximate population burden of 100-110 million persons with high blood pressure (BP). Approximately half to two-thirds of these are stage I hypertension (systolic BP 140-159 and/or diastolic BP 90- 99 mm Hg) and the rest have stage II -III disease.

Senior cardiologist Dr KK Agarwal from Indian Medical Association (IMA) prefers not to discuss what range should define high blood pressure.

“I would rather advice that every person should ensure that his BP should not be more than 120/80. One should become health alert once the BP is on the higher level. While what and when drug should be taken will be decided by the doctors but one should immediately change his or her lifestyle,” he said.

Dr Daljit Singh, Director and Professor of Neurosurgery, GB Pant Hospital said that the AHA guidelines are followed all over the world and it was not surprising that we will not follow them sooner or later. He said that the good aspect of lowering the level is that it will make more people alert about their health condition as they would be taking care of their health by changing their lifestyle.

On the other side, this means more drugs sale and more projects as more people will come under the ambit of the high blood pressure definition, said Dr Singh.

Another doctor, who did not want to be named, too said that sometimes drug companies are also behind such decisions.

Dr Sundeep Mishra, Professor of Cardiology from AIIMS called the new AHA range as ‘highly ambitious.’ “It will only create panic among people. If we go by the new range, at least 60 per cent of our population will fall under the high blood pressure category. They will have to take drugs,” he said.

The American guidelines are meant for developed countries and not for developing nations. However, Dr Sundeep Mishra suggested that keeping the blood pressure in check can prevent things like heart disease, stroke, heart attack and kidney disease.