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Mind the pressure

THE WEEK India

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June 01, 2025

Hypertension is a long-term condition that can be managed with continuous attention

- PUJA AWASTHI

Understanding hypertension

Also known as high blood pressure, it is a condition where the force of blood pushing against the walls of your arteries is consistently too high. Imagine your heart as a pump and your arteries as pipes. If the pressure inside those pipes becomes too strong over time, it can damage the walls and strain your heart.

Measuring blood pressure

There are two numbers: systolic (when the heart beats) and diastolic (when the heart rests between beats). For example, if your reading is 120/80mmHg, 120 is the systolic and 80 is the diastolic pressure. A normal blood pressure reading is less than 120/80mmHg. When blood pressure remains high for a long time, it increases the risk of problems like heart attack, stroke, kidney disease and vision loss. The danger with hypertension is that it often shows no symptoms, which is why it is commonly called a 'silent killer'.

Understanding the ranges

At stage one, systolic is between 130 and 139, and diastolic between 80 and 89. Stage two is when systolic is 140 or higher, while diastolic is 90 or higher. It is a hypertensive crisis when systolic is over 180 and diastolic is over 120.

How Indians differ from Caucasians

Indians tend to develop heart disease at a younger age and at lower body weights compared with western populations. We also have a higher prevalence of salt sensitivity, central obesity, insulin resistance and early onset of diabetes. All of these make us more vulnerable even at borderline blood pressure readings.

Many Indian doctors prefer to intervene earlier, sometimes even during the 'elevated' phase, especially if the person has additional risk factors like family history, diabetes or obesity. This is because studies have shown that cardiovascular events in Indians often occur without warning and at lower blood pressure thresholds.

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