Uncontrolled hypertension in the young can raise risk of heart failure, vision loss and cognitive decline: Doctors

Global data, according to Dr Prashant Nair, consultant, cardiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, suggest that over five per cent of adolescents have hypertension and 14 per cent have elevated BP levels (prehypertension).

A recent study from India showed a prevalence of over seven per cent for adolescent hypertension. In India, high prevalence of hypertension among young adults (20â€"44 years) is also found. The prevalence in this age group is more than twice the prevalence in a similar population in the United States. "This is a disturbing trend because it puts an increasing number of young Indians at an increased risk of premature mortality due to cardiovascular causes," highlights Nair.

Similarly, Dr C. K. Ponde, section head, invasive and non-invasive, consultant, cardiologist, P. D. Hinduja Hospital & MRC, Mahim, says, "Young adults are at risk of hypertension. This is due to several social and lifestyle-related factors. Many Indian studies have shown that the prevalence of hypertension in the young group â€" between the age group of 20-45, has significantly increased over the past 10 years. Today, one in four young adults living in urban areas have hypertension and sadly only half of them are aware that they suffer from it. Out of which, only half take proper treatment."

Ahead of World Hypertension Day, observed annually on May 17 to raise awareness and promote the prevention, detection, and control of hypertension, Mid-day.com conversed with health experts who shed light on the increasing number of young adults having hypertension and tips to keep it under check for living an overall healthy life.

Hypertension, also known as high blood pressure, is a medical condition that is characterised by elevated pressure in the arteries. Blood pressure is the force exerted by the blood against the walls of the arteries as it circulates through the body. Dr. V.K.G. Rajasekar, chief director, cardiology, Artemis Cardiac Care and GEM Artemis Heart Centre, Chennai, states, "When the pressure remains consistently high over time, it can cause various health complications, like heart disease, stroke, kidney damage, and vision problems."

Normal and elevated blood pressure
"Normally any blood pressure above 130/85 is considered high. As per new guidelines, any blood pressure above 120/80 is considered high/normal," says Ponde.

Rajasekar elucidates, "Blood pressure measurements basically consist of two numbers: systolic and diastolic pressure. The systolic pressure represents the force of blood against the artery walls when the heart beats, while the diastolic pressure is the pressure when the heart is at rest between beats."

The basic blood pressure chart is as follows:
1. Normal:
- Systolic: Less than 120 mmHg
- Diastolic: Less than 80 mmHg

2. Elevated:
- Systolic: 120-129 mmHg
- Diastolic: Less than 80 mmHg

3. Hypertension Stage 1:
- Systolic: 130-139 mmHg
- Diastolic: 80-89 mmHg

4. Hypertension Stage 2:
- Systolic: 140 mmHg or higher
- Diastolic: 90 mmHg or higher

5. Hypertensive Crisis:
- Systolic: Higher than 180 mmHg
- Diastolic: Higher than 120 mmHg

It's important to understand that a single high reading doesn't necessarily mean you have high blood pressure. Diagnosis generally involves multiple readings over time.

Causes of hypertension in young adults
Ponde highlights four main causes of hypertension in young adults.

1. Sedentary lifestyle
2. Regular high salt intake
3. Fast food and fatty food that leads to the expansion of body mass index or obesity
4. Psycho-social stress at the workplace and in nuclear families

Additionally, Rajasekar shares, "Poor dietary habits, low consumption of fruits and vegetables, obesity, excessive alcohol consumption, and smoking, lack of adequate sleep, and underlying health conditions like diabetes or kidney disease can also elevate blood pressure in young people."

Health risks of hypertension in young
Hypertension in young people can cause various health complications and risks, including an increased likelihood of developing cardiovascular diseases like heart attack, stroke, and heart failure at a younger age.

Also, uncontrolled hypertension can damage blood vessels and organs over time, leading to kidney disease, vision loss, and peripheral artery disease.

Hypertension also increases the risk of cognitive decline and dementia later in life.

Furthermore, it can complicate pregnancies in young women, increasing the risk of preeclampsia and other pregnancy-related issues.

Early detection, lifestyle modifications, and appropriate medical management are necessary to prevent and manage these potential health risks.

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Symptoms of hypertension in young
According to Nair, "Most people with hypertension don't feel any symptoms. However, very high blood pressure can cause headaches, blurred vision, chest pain and other symptoms."

People with very high blood pressure (usually 180/120 or higher) can experience symptoms including:

Severe headaches
Chest pain
Dizziness
Difficulty breathing
Nausea
Vomiting
Blurred vision or other vision changes
Anxiety
Confusion
Buzzing in the ears
Nosebleeds
Abnormal heart rhythm

It's important to understand that these symptoms can vary widely among people. Regular blood pressure monitoring, especially for those with risk factors, is necessary for early detection and appropriate management of hypertension in young adults.

Treatment to keep high blood pressure in check
As stated by Ponde, "Key lifestyle modifications like a healthy diet and stress management activities are recommended to keep hypertension within normal limits. However, in cases of critical high blood pressure, multiple drugs can be used such as ACE inhibitors, ARBs and calcium blockers. These drugs in combination or isolation are effective in treating hypertension."

Additionally, Rajasekar says, "It's important to maintain a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while limiting sodium, saturated fats, and added sugars is crucial. One must include plenty of fruits, vegetables, whole grains, lean proteins like poultry, fish, tofu, and legumes, and healthy fats from sources like nuts, seeds, and avocado. Emphasising fiber-rich foods, like fruits, vegetables, and whole grains, helps in maintaining a healthy weight and promotes heart health."

Foods to strictly avoid or limit are those high in sodium, saturated fats, and added sugars, such as processed foods, sugary beverages, fried foods, and excessive amounts of red meat. Minimising intake of these foods helps in having good overall health and helps in preventing conditions like obesity and hypertension.

Further, Regular physical activity, like brisk walking, swimming, or cycling, helps in lowering blood pressure and improve overall cardiovascular health. Managing stress through relaxation techniques like deep breathing, meditation, or yoga can also be beneficial. Avoiding tobacco use and limiting alcohol consumption are essential. Furthermore, ensuring an adequate amount of quality sleep at night promotes healthy blood pressure levels.

Regular monitoring and follow-up with doctors are necessary for tracking progress and making adjustments as needed."

Reversing high blood pressure in young adults
While Ponde and Rajasekar mention that high blood pressure in young adults can be reversed provided one maintains optimal body weight, very low sodium intake, a balanced diet, and manages stress, Nair says, "Whether or not hypertension can be cured largely depends on what is causing it. It helps to understand that there are two main types of high blood pressure â€" Primary (or essential) hypertension, a high blood pressure that is not caused by an underlying medical condition or medication, which affects 90 per cent of people with hypertension and secondary hypertension which is high blood pressure that is caused by another medical condition or by medication. This accounts for about 10 per cent of hypertension cases.

Nair opines, "Primary hypertension cannot be completely reversed. But that doesn't mean everyone with this kind of high blood pressure needs to take medication. Some people can keep their blood pressure within a healthy range with lifestyle changes. But that requires sustaining these habits long term. However, in some cases, secondary hypertension can be cured by treating the underlying condition."

In conclusion, early detection, lifestyle modifications, and appropriate medical management can help in preventing and managing the woes of hypertension.

Disclaimer: This information does not replace professional medical advice. Consult a qualified specialist or your physician for personalised guidance.