CHENNAI: Dubbed as the ‘Silent Killer’, hypertension is a disease with little to no symptoms, which, according to a recent study, not many are aware of having. Its quiet nature is what makes it more deadly, say experts, and so one must have regular check-ups. The India Heart Survey conducted a study this year with nearly 3,000 participants from Tamil Nadu, only to find that nearly 46 per cent of responders, whose median age was 42, were unaware of having hypertension (HTN)
What is HTN?
HTN is classified as a long-term condition with consistently elevated blood pressure in the arteries. The normal blood pressure has been qualified as 140 mm of mercury systolic over 70 mm of mercury diastolic. Any figure higher than this signifies that the person has HTN.
According to Professor R Alagesan, retired professor and HoD Cardiology, Madras Medical College, Chennai, “There are no overt symptoms that are specific for HTN. The symptoms are the damage to the target organs — the heart, the kidneys and cerebrovascular system. This is why it is called ‘the silent killer’. Interestingly, symptoms occur only when I tell patients that they have HTN when they tell me that they have headache, or experience giddiness.”
Nearly 90 per cent of patients have no immediate cause for HTN. Pituitary disease or narrow blood vessels, pregnancy or smoking, sleep apnea or diabetes can be causes for the disease. Men, elders, African-Americans, as well as those with a history of HTN are more likely to have the disease.
HTN can have a long-term impact on kidney health, says Dr Georgi Abraham, head, Nephrology Department, Madras Medical Mission, Chennai. The blood vessels in the kidney, the capillaries, are thin vessels which purifies blood. Kidney has a mechanism to reduce the pressure of the blood in the capillaries. “When one has HTN, the walls of the capillaries become large to combat the high pressure, as a kind of self-defence mechanism. This is called atherosclerosis. Over time, the blood vessels will become narrow, and thus the filter receives less blood flow, which leads to dysfunction,” he said.
Both doctors stress the importance of routine health check-ups, both at home and at the clinic, for an effective diagnosis. Combating HTN requires lifestyle changes which includes a healthy diet and exercise. Patients having higher blood pressure levels are required to take regular medication for the rest of their lives.
Dr Viraj Suvarna, president – Medical, Eris Lifesciences and his team conducted the study with the India Heart Study. “Before conducting the study, we had data that suggested that, as per the rule of halves, only 50 per cent of people with chronic ailments will be aware that they have a disease. Studies in India, conducted on a smaller-scale, suggested the same. Our study shows that quite a few people in India are unaware that they have hypertension,” he said.
The reason for 46 per cent of respondents to be unaware could be due to lack of symptoms or poor lifestyle habits and health consciousness. Not many people come to check their blood pressure, he added, but it is also crucial for patients to check their blood pressure at home for an effective diagnosis. This is due to white-coat HTN, where blood pressure readings are higher at the doctor’s clinic.
“Seventy-three million people in India suffer from diabetes, but when it comes to HTN, the number can be 400 million. Yet people do not take it seriously, which could be due to lack of education or awareness, or flippancy. People will insure their cars, but not invest in life insurance,” he said.
The study also revealed that the participants had a higher than average heart rate, with the average heart rate being at 82 beats per minute, which is 10 beats higher than the average. The blood pressure was measured twice a day, and the evening blood pressure is normally lower than the morning blood pressure. However, the participants recorded higher evening blood pressure levels than morning blood pressure levels.
“When your resting heart rate is consistently higher, it means that there is an imbalance between the sympathetic and parasympathetic nervous systems. Sometimes, this can cause atrial fibrulation, a disorder in the heart that can cause clot formations. Our study showed that 5.7 per cent of participants had this, which is an alarming thing,” he said.
Dr Viraj emphasised the importance of recording blood pressure levels regularly and done so with a validated blood pressure checking device which is accurate and tested under a protocol by international bodies. Measuring blood pressure well can only lead to a proper treatment of the condition, he said.
“Patients must be compliant in taking medication, and checking blood pressure levels at home leads to them being more regular with their medication. This will help doctors know how to properly treat their patients. People must make themselves aware of this disease because this disease is the silent killer,” said Dr Alagesan.
Change your lifestyle
Doctors stress the importance of routine health check-ups, both at home and at the clinic, for an effective diagnosis. Combating HTN requires lifestyle changes which includes a healthy diet and exercise.