Hypertension alert: Lower BP with exercise as every kg of weight loss equals effects of a pill

Cardiologist Dr Ambuj Roy, who runs the hypertension clinic, doesn’t find such cases surprising at all. “That’s because 90 per cent of the hypertension cases are essential, meaning they don’t have one distinct cause and could be multifactorial. That’s why you have got to manage it with medication and lifestyle correction measures like diet, exercise and sleep,” he says. Worst of all, most patients experience no symptoms of hypertension. That’s why it is referred to as the silent killer. “Left undiagnosed and untreated, hypertension increases the risk of stroke, heart attack and kidney failure. That’s why young people should start regular screening, at least once a year, beginning at the age of 25,” says Dr Roy.

Exercise is a key component of the early adoption of a heart-healthy practice. “Everyone should exercise at least 25 to 30 minutes for five to six days a week. Even if your weight doesn’t go down, it can still bring down your BP. Every kilogram that a person sheds can bring down their BP by as much as a pill would,” says Dr Roy.

Nearly 315 million Indians live with hypertension. However, only one in three get diagnosed and one in five get treated.

WHAT ARE RISK FACTORS

In Kotnala’s case, unchecked hypertension had led to a clot in his kidneys. Once that was removed, his BP went down. Now he never misses taking BP-lowering medication, exercises regularly and has a healthy diet to keep his numbers in check.

Sharma didn’t have common risk factors of hypertension like family history, cholesterol, obesity or diabetes. But he drank once a week and smoked a couple of times a day. Studies have shown how even one alcoholic drink per day constricts your blood vessels over time, pushing the heart to pump blood harder and raising BP overtime. Nicotine in cigarettes stimulates the release of hormones that increase blood pressure.

Sharma was stressed at work and slept poorly. And though he thought he was eating moderately, confining himself to two meals every day, he was overloading himself with carbohydrates and had little protein to build lean muscle mass and cut down fat. Worse, his twice-a-day dal-chawal or roti sabji combinations were fatty and salty. He had a caloric overload and imbalance. “Now, I eat everything with less salt and oil. I have stopped smoking and drinking altogether,” says Sharma.

NEVER GIVE UP MEDICATION, STICK TO DIET

Once BP levels swing back in range, people make the classic mistake of lowering dosage or giving up drugs on their own. “It is a myth that long-term dependency on BP-lowering medicines will cause side-effects. Medicines keep your blood pressure in check. The only effect of long-term use of the medicine is a reduced risk of heart attack, stroke and heart failure,” says Dr Roy.

When it comes to the diet, everyone should aim to include more fruits and vegetables in their diet — at least four to five servings. “It is a difficult ask — we have one of the lowest per capita consumption of fruits and vegetables. But seasonal fruits and vegetables are not very expensive. Having fruits like bananas that are rich in potassium brings down sodium levels. Use less salt, which is known to drive up blood pressure,” he adds.

Above all this is stress, the threshold of which is difficult to measure. “Take some time each day to relax and calm down. This helps in bringing the balance back to the sympathetic (the system that controls the body’s fight or flight response to crisis) and parasympathetic nervous system (the system that controls the at-rest functions). This balance is essential for keeping blood pressure in check,” explains Dr Roy.

WHAT SHOULD YOUR SCREENING PROTOCOL BE

Beginning at 25 years, one should get at least an annual screening done. “Those with a lower BP reading of 110/70 mm/Hg may wait two years for their next screening. Those sitting on the fence at 120/80 mm/Hg, however, should be screened every six months for hypertension. In general, I would say, everyone should check their blood pressure at least once a year,” says Dr Roy.

(Graphic: Dinkar Sasi)