Mumbai, India: One of its kind study has reported that one in five young adults in India has high BP. This turns up to be around 8 crore people which is more than the entire population of many countries. The results are really alarming and portray the current decline in health consciousness among Indian youth.
The findings of the research were presented at the 70th Annual Conference of the Cardiological Society of India (CSI). CSI 2018 was held from 22 to 25 November in Mumbai. Joint scientific sessions were held by the European Society of Cardiology (ESC) and CSI as part of the ESC Global Activities programme.
“There is a need to increase awareness among general public and doctors as well since hypertension is usually considered a disease of middle age and escapes detection till end-organ damage starts,” study author, Dr. Kartik Gupta, PG 3rd year, Department of Medicine, AIIMS, New Delhi told Medical Dialogues.
“One in five young Indians in age group 18-39 years has hypertension according to JNC7 criteria and only 15% of those with high bp were on treatment with almost half having uncontrolled blood pressure,” he added.
According to Dr. Kartik Gupta, high blood pressure hits Indians at a younger age than western populations, and first heart attacks and strokes occur a decade earlier on average. India’s screening programme typically starts at 30, which is too late.
“We need to screen and promote healthy lifestyles early to avoid the crisis India is heading for. Over 50% of Indians are under 40 – this is the most economically productive group and India is banking on them for its development, said Dr. Gupta.
The Great India BP Survey was conducted in 24 Indian states, from 9 am to 5 pm on a single day. Blood pressure was measured in public places such as metro stations, bus stops, and marketplaces. Readings were repeated in those with high blood pressure (more than 140/90 mmHg). Participants were asked about risk factors for hypertension including smoking and chewing tobacco, diabetes, and high cholesterol, as well as previous heart attack or stroke, and whether they were taking blood pressure drugs.
Blood pressure was recorded in around 180,000 Indian adults. Of those, 89,210 were 18–39 years old and are the focus of the current study. The average age was 28 years and two-thirds were men
The key study findings included are:
- The prevalence of hypertension was 19%. Just 15% of people with hypertension were on treatment and of those, 49% had uncontrolled blood pressure.
- The level of self-reported risk factors was: smoking 7.5%, tobacco chewing 6.6%, diabetes mellitus 2.1%, and high cholesterol 2.2%. Analyses revealed that the risk factor most strongly related to hypertension was diabetes, which was associated with a doubled risk of developing high blood pressure.
Dr. Gupta observed that risk factors were likely underreported. He said: “National data shows that 5–10% of Indians have diabetes, 25–30% chew or smoke tobacco, and 20–30% have high cholesterol. Indians hardly exercise at all, and the diet is traditionally high in salt. Consumption of vegetables and fruits is low and western junk food and soft drinks have become increasingly popular.”
“The main message from our study is that we should start screening for hypertension at 18–19 years of age,” said Dr. Gupta. “It could become part of the physical examination for those who attend college. In addition, school children need education about being physically active, keeping body weight down, eating healthily, and avoiding tobacco. This would prevent many people from developing high blood pressure, diabetes, and high cholesterol.”
For study participants found to have hypertension, Dr. Gupta said they should visit their GP to confirm that their bp is consistently higher than 140/90 mmHg before starting medication. He added: “When adults come to see a doctor for any reason we should routinely measure their blood pressure.”
Professor Kewal C. Goswami, CSI President-Elect and Chairman of the CSI 2018 Scientific Committee, said: “Until now we did not have a clear picture of the extent of hypertension in young adults in India. We need to do more to prevent and treat high blood pressure. This includes tackling our high salt consumption and low levels of exercise.”
Professor Marco Roffi, course director of the ESC programme at CSI 2018, said: “ESC guidelines recommend a healthy lifestyle for all patients with high bp, as it can delay the need for drugs or complement their effects. In patients who start medication, ESC guidelines recommend taking two drugs as a single pill to make adherence easier.”
High bp (hypertension) is the leading global cause of premature death. It is a major risk factor for heart attack, stroke, heart failure, atrial fibrillation, chronic kidney disease, and cognitive decline.