High BP is mostly asymptomatic

High blood pressure or hypertension is called the silent killer, which has impacted millions across the globe. The condition, which was more prevalent in elderlies before, is now getting increasingly common in the younger population as well.
Causes of raised BP can be hereditary or non-hereditary (which basically means it happened because of secondary causes). For those who fall in the former category, the condition manifests itself between the age of 40 to 60, for the latter, it is primarily caused by lifestyle related issues such as smoking, drinking, poor eating habits, lack of exercise and can start showing its ugly face between the age of 25 to 40 years. Doctors today are increasingly witnessing non-hereditary cases and they warn that if not tackled in time, it can prove to be highly dangerous.

Dr Santosh Kumar Dora, Senior Cardiologist, Asian Heart Institute, Mumbai, shares, “The prevalence of high BP is 22% in age less than 20 and 44% in the age group of 20 to 44. In my practice, more than 50% of cases belong to the age group of 20-40 years. This is a worrying trend. The common causes of such high incidence of hypertension are lack of exercise, obesity, high salt intake ( i.e fast foods), smoking etc. Action should be taken at all levels including individuals to institutions and government organizations to promote healthy lifestyles to prevent hypertension.”
It is interesting to note that a New York-based study in 2016 showed that 95% of people suffering from hypertension were completely asymptomatic. It means that you may never know that you are having high BP. As per a recent study in India, the prevalence of BP is as high as 50% by the age of 45 or more. So if you are aged 50, there is 50% chance that you may be hypertensive and 95% chance that you may not be having any symptoms. 5% of hypertensive patients who are symptomatic may have, headache, confusion, giddiness, vision problem etc. One should not ignore these symptoms and promptly take medical advice if present.

So let’s start by understanding the high blood pressure reading. Dr Dora explains, “World Health Organization defines high blood pressure as systolic BP of 140 mm Hg or more and diastolic BP of 90 mm Hg or more. However, American Heart Association has stricter criteria. It defines Stage I Hypertension as systolic BP of 130 mm Hg or more and diastolic BP of 80 mm Hg or more. Systolic BP of 140 mm HG or more and diastolic BP of 90 mm Hg or more are defined as stage 2 hypertension.”

Often people see huge fluctuations in their blood pressure, giving rise to doubts about whether they are even measuring it the right way. Blood pressure measurement at a doctor's clinic often gives a slightly higher value and may not confirm that the patient is suffering from hypertension. This is commonly known as white coat hypertension, adds Dr Dora. Out of office and self monitoring of BP is recommended for confirmation of diagnosis of hypertension and titrating of BP lowering medications. 24 hour ambulatory blood pressure measurement by a machine which is attached to the arm gives a much better real time estimation of BP both during day time and night time and has much more diagnostic accuracy than a single time office BP measurement.

Those who have a systolic BP of 130 mm Hg or more and diastolic BP of 80 mm Hg or more do not have to worry too much, however, they need to realise that in future the BP may further increase, which can lead to irreversible damage. Thus, it is very important for such people to begin aggressive lifestyle modifications like low-salt diet, low-fat diet, weight reduction, smoking cessation, regular aerobic exercise, decreased stress etc. Patients with systolic BP of 140 mm hg or more and diastolic BP of 90 mm Hg or more should be taken seriously and should consult a doctor to know the further course of action.

Role of Covid-19 in rising cases of hypertension

The entire population is right now under lockdown and undergoing immense stress levels. “Many people have lost their jobs. There is tremendous financial stress and stress is an important risk factor for hypertension. The other thing is lack of physical exercise due to lock down as people cannot come out of their home. However, this can be partly compensated by doing some yoga and floor exercises at home itself.”

Dr Charu Sachdeva, Head of Internal Medicine, Manipal Hospitals, Dwarka Delhi shares, “Hypertension is associated with coronary artery disease and cerebrovascular disease, 2 conditions that are on a rise and have a high morbidity and mortality risk. Hypertension worsens kidney disease. The biggest problem is it is generally detected late since people may not be symptomatic till the pressures are quite high, hence there is unawareness leading to ignorance. Guidelines are constantly being revised to ensure maintaining an optimum blood pressure so complications may be avoided.”

The only way to know whether you are suffering from high BP or not is to check it periodically. A regular yearly health check-up will tell you your BP. It is a good practice to buy a digital BP machine and check BP intermittently at home even if you are not hypertensive. It becomes a must to buy it and check BP at home, if you are hypertensive and are taking measures to normalize it by drugs or by other methods.

Symptoms to watch out for...

The symptoms that may appear generally if blood pressure is quite high can range from simple headaches, dizziness, numbness to more severe symptoms of stroke and heart failure.