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Journalism of Courage
Like any teenager, 20-year-old Raman (name changed) loved noodles as his go-to food. He was borderline obese but everybody attributed his plumpness as a normal part of adolescence, thinking he would outgrow his puppy fat as he adulted in time. So two years ago, his parents were in for a rude shock when he fainted while watching TV and slumped to the floor at their Pune home. He had a hypertensive emergency as his blood pressure levels had skyrocketed to 200/140 mmHg as against 120/80 mmHg. He was just 18 then.
Termed malignant hypertension, doctors tried to check for organic causes like narrowing of the aorta, renal artery stenosis (underlying kidney diseases can raise BP) or adrenal gland tumour. But he was diagnosed with “essential hypertension,” which basically means “his high blood pressure was not due to any medical condition,” recalls Pune-based Dr Vijay Natarajan, cardiac surgeon and Director of Surgical Services at Bharati Hospital. However, the wake-up call helped him alter his lifestyle and with daily exercise, he has lost 20 kg now but continues to be on a low dose of medication. Hypertension is a silent killer and one cannot take it casually regardless of whether you are young or old, say cardiologists adding that the target blood pressure should still remain 130/80 mmHg.
How does lifestyle play a role in hypertension among the young?
Blood pressure levels rise in young people in their academic years largely due to their sedentary habits, school work, tutorial and assignment commitments. This is also the time when they indulge in food exploration and go for unhealthy diets (high on sugar, refined carbohydrates, salt, trans or saturated fats). Although they could be disciplined in their childhood to have fruit, vegetables, and nuts, they abandon these as they enter their teens. Then once they become adults and join workplaces, they fall into predictable patterns of addictive peer behaviour — keeping long hours at work, battling stress, getting inadequate sleep, indulging in alcohol binges or smoking and dealing with troublesome inter-personal relationships. “When these forms of assaults on the blood vessels continue over time, hypertension becomes sustained,” explains Dr K Srinath Reddy, honorary distinguished professor at the Public Health Foundation of India (PHFI). Adds Dr Natarajan, “Unknowingly the younger generation is at a higher risk because of their craving for fast food and eating out. Their daily intake of salt and fat goes up much higher than the recommended daily allowance (RDA).”
What is the long-term impact of hypertension on the health of young individuals?
It exacerbates their predisposition to metabolic disorders like diabetes, obesity and heart attacks. According to Dr Reddy, “prolonged damage to blood vessels due to uncontrolled hypertension results in heart attacks, brain strokes, kidney failure and congestive heart failure. Over time and with advancing years, hypertension may cause aneurysms of the aorta, peripheral vascular disease, loss of cognitive function, vascular dementia and loss of vision.”
What are triggers that the young need to know about?
Sedentary lifestyle, addiction to foods high in salt content, MSG, polyunsaturated fats, irregular sleeping habits, smoking and alcohol are among the factors that have led to the increasing prevalence of hypertension among the youth, feels Dr Natarajan. “Besides abnormal obesity is on the rise, carrying the penalty of hypertension. Air pollution has emerged as a major factor as it has now been proven to cause hypertension. As air quality deteriorates, blood pressure levels rise in the community,” says Dr Reddy.
Are there any specific genetic or hereditary factors that predispose some young individuals to hypertension?
A strong family history of hypertension certainly predisposes a young adult to premature hypertension. “This is a polygenic disorder that has a familial tendency. Gene-environmental interactions play a strong role. If either or both parents have had hypertension in youth or middle age, the risk goes up in their offspring. There is also the phenomenon of ‘anticipation’ in such cases, where the children manifest hypertension at an age earlier than the parents. Adopting healthy living habits may avert or attenuate this hereditary influence. There are congenital disorders like coarctation of aorta, kidney or adrenal diseases which can lead to hypertension,” explains Dr Reddy. “Early detection and treatment can prevent future morbidity and early mortality,” advises Dr Natarajan while Dr Sunil Sathe, consulting cardiologist at Ruby Hall Clinic, appeals not to take hypertension casually. “At least 80-90 per cent of youngsters do not have symptoms and then come in with sudden complications. Do not neglect your BP status and see that you keep 130/80 mmHg as your target. That should be the aim,” he says.
Do not stop prescribed BP medication
Dr Devi Prasad Shetty, noted cardiac surgeon and chairman and founder of Narayana Health, says many people drop their BP medication and trust Instagram posts on regulating hypertension, which is the most dangerous behaviour. “Over the past few days, there have been multiple articles on social media promoting a fictitious drug called cardiotonin by an unknown company, claiming to treat high blood pressure. Unfortunately, my photograph was used without permission and a fabricated interview was published. Moreover, false quotes from reputable medical journals are endorsing this fake drug. There is a need to help spread awareness about the dangers of health-related fake news and its potential consequences,” he says.
Medicines, he insists, are the only treatment for high blood pressure. “Initially, weight loss and lifestyle changes do help. However, if the pressure continues to remain high, then it needs to be managed by taking medicines daily in consultation with your medical practitioner who will decide what works best for you. The problem of stopping medication is that the blood pressure can rise fast and lead to brain stroke, heart failure and other problems. So do not stop blood pressure medicines unless your physician tells you to. Uncontrolled blood pressure causes severe damage – as the brain vessels can tear, the heart and kidney functions can fail,” cautions Dr Shetty.
WHAT CAUSES YOUNG AGE HYPERTENSION
1. Sedentary lifestyle
2. Addiction to foods high in salt content, MSG, polyunsaturated fats
3. Irregular sleeping habits
4. Smoking and alcohol
5. Work or relationship-related stress
6. Obesity, particularly abdominal obesity
