Blood Pressure

Blood pressure is a dangerous, silent, killer, with no cure.

You cannot eliminate it, but you can tame it enough to ensure it does no harm.

If you are lucky and your normal blood pressure 158 is within limits, you just need to be smart enough not to screw up and allow it to increase to dangerous levels – which it will if you are irresponsible with your food and other lifestyle habits.

If your normal blood pressure is on the higher side (you have hypertension), you need to take extra bits of effort through medications, exercises and diet control.

If there are only three simple to-dos I would request readers to take back from my experiences, they would be:

  1. Get tested for hypertension – This takes just a minute if you have access to a blood pressure monitor or perhaps an hour if you need to visit your local doctor.

Don’t assume you don’t have it, especially if you are over 40. Many people with hypertension do not have any symptoms. I came to know that I had hypertension because one day late last year, after checking amma’s BP, I checked my BP just for fun, only to be shocked to see the reading at 140/90. Subsequent readings and testing at hospitals showed that mine averaged around 135/90, still outside of the comfort zone. 159

Worldwide, a larger proportion of men have blood pressure than women. So if you are a male, you may want to show extra urgency in getting tested. 160 And do not be under the misconception that if you are lean, you do not have hypertension. At least in the context of hypertension, thin doesn’t mean a win. 161

Basically, just get your blood pressure tested. Is it asking for too much?

  1. If you have hypertension, the smartest thing would be to ensure that you do not get into trouble at all, by being rigorous in taking the BP medication, or if you are confident and motivated enough, make significant changes to your food, activities and exercises. Else, you could be dead tomorrow, or worse, you could be a dead man walking for years.
  1. Invest in a simple blood pressure monitor. And make sure you use this at least twice a month.

If I sound alarmist about blood pressure, I’m fully justified in doing so. Such a lethal, highly prevalent ailment is somehow not generating the kind of fear it should, even among people in developed countries.

In 2019, the British Heart Foundation released a warning that about 10% of the country’s population in the 16-64 age group are living with undiagnosed high blood pressure – about 4 million in all. The Foundation interestingly called such undiagnosed BP as “ticking time bomb” – the global cardiovascular discipline certainly seems to have an affinity for time bombs. Britain today has four million ticking time bombs happily ignorant of their precarious ailment and living as if there were no tomorrow – for some of them, there actually might not be one. While the percentages and numbers for the UK may not look scary enough, it is worth remembering that this country has seen one of the most successful programs to reduce hypertension. 162

Let’s zoom to America. The US has about 250 million adults (over 18 years of age), with 29% of them having hypertension. A 2017 study by CDC noted that slightly over 50% of American adults having hypertension are not keeping it in control – that would be about 36 million Americans. 163 Most of these millions know that they have hypertension, and that it could maim them badly, but they can’t yet do a simple thing like taking a blood pressure pill regularly. For these folks, somehow, a probable catastrophe tomorrow doesn’t appear to be as important as the certain trivialities of today.

If wealthy, educated countries such as the US and Britain have significant percentages of their populations either unaware of or not in control of their blood pressure, what could it be in a developing country like India?

A 2019 study released on World Hypertension Day (May 17) suggests that about 62% of urban and over 75% of rural Indian population with hypertension are not on treatment. 164 At India’s current population, this could be well over 100 million. That’s simply humongous.

Fig 50: Hypertension trends worldwide: All regions of the world have a significant burden of people with treated hypertension, but developing countries like India and underdeveloped countries share a large part of the global untreated hypertension burden.  

According to WHO, over 1.1 billion people worldwide have hypertension, with two thirds of them living in low and middle income countries. 165

I did some calculations using the above data points and using some appropriate extrapolations. My estimate says that worldwide there would currently be about 750 million ticking time bombs – people who have hypertension but are not aware of it or are not taking steps to keep it under control.

That’s 10% of the world’s population, and about 20% of those over 30. 166 Scary.

If you are over 30 and assume you do not have hypertension, there’s a one in five chance that you are wrong.

And that can be a very costly error.

HEALTH AND MEDICINE <= Blood pressure => Smart health management



158. Latest standards worldwide recommend levels below 120/80 for systolic and diastolic blood pressure.

159. I have been taking a small dose of a hypertension medication since the beginning of 2020

160. Studies have shown that while men under 50 are more likely to have hypertension than women, post their menopause, women are actually more likely to have hypertension than men. The average age for the end of menopause is about 50. So 50 years appears to be the inflexion point when hypertension prevalence shifts from men to women.

161. A 2008 study suggested that a surprising number of overweight people – about 50% – have normal blood pressure and cholesterol levels, while an equally startling number of trim people suffer from some of the ills associated with obesity.

162. The UK’s salt reduction programme, initiated by the Food Standards Agency and Consensus Action on Salt & Health, has been considered a significant success. It involved a collaborative effort with the food industry to reduce salt in the nation’s diet.



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