A person can suffer from high blood pressure at any time in life. It does not depend on age, as, nowadays, we find even young adults suffering from high BP, heaviness in the chest, a swinging head and rapid heartbeats. We, Indians, tend to take things lightly and, often, take things in our own hands. We even try self-medication! This lack of awareness complicates matters. And, at times, doctors, too, can go wrong.
Findings of the India Heart Study (IHS) show that 22.5% of respondents from West Bengal were white-coat hypertensive, while 17.3% were found to have masked hypertension, thereby putting almost 40% people at risk of misdiagnosis and ‘missed’ diagnosis. There were 862 participants from the state, 622 of them males and 240 females.
‘Masked’ hypertension is a phenomenon in which an individual’s blood pressure reads normal at the doctor’s chamber, but runs high at home; ‘white-coat’ hypertension is defined as a condition in which people exhibit a blood pressure level above the normal range only in a clinical setting. White-coat hypertensives who are misdiagnosed and put on anti-hypertension drugs have to take unnecessary medication. On the other hand, a masked hypertensive may go undiagnosed, running the risk of complications of the heart, kidneys and brain, leading to premature mortality.
The India Heart Study (IHS) findings highlight a high prevalence of masked hypertension and white-coat hypertension in Indians at 42% on first office visit (doctor’s clinic). It was also found that Indians have an average resting heart rate of 80 beats per minute, higher than the desired rate of 72. Another striking finding of the study is that, unlike in other countries, Indians have higher blood pressure in the evenings than in the mornings, which should guide doctors to rethink the timing of advising anti-hypertension drug dosage.
Dr Upendra Kaul, cardiologist, Chairman and Dean, Academics and Research, Batra Hospital and Medical Research Centre, who was the principal investigator of the IHS, says, “The IHS findings underscore the need for better clinical management of hypertension in India. This is India-specific data and should help shape best practices for diagnosis of high blood pressure among Indians. The study presents exhaustive data on the various aspects of hypertension.”
Dr Viraj Suvarna, President-Medical, Eris Lifesciences, warns, “Masked hypertension, if undetected, is dangerous. It’s important to monitor one’s blood pressure beyond the clinic, even at home, according to prescribed guidelines. Accurate diagnosis of hypertension is an important element of our fight against this disease and improving health outcomes.”
Dr Soumitra Kumar, Professor and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences and Ramakrishna Mission Seva Pratishthan, Kolkata, and a coordinator for IHS, has this to say, “There’s a close link between high blood pressure and cardiovascular diseases, which are on the rise in our country. We need to take the right measures to cut down on the risks by monitoring our blood pressure regularly and leading a healthy lifestyle. The IHS has provided us with insights on the prevalence of white-coat hypertension, masked hypertension and resting heart rates pertinent to the Indian condition.”
According to Dr Lalit Kumar Agarwal, nephrologist, Woodlands Hospital, “Kidneys, which serve as a critical organ in our body, are at high risk of damage in people with high blood pressure, or hypertension. In people at risk, achieving lower, or optimum, target BP is known to be beneficial in reducing the chances of kidney disorders.”
What’s special about the study
- What sets this study apart is that it was conducted on a ‘drug-naive’ set (people not on any anti-hypertension drug) of participants using a comprehensive process of taking blood pressure readings
- The investigators examined the blood pressure of 18,918 participants (both male and female) through 1,233 doctors across 15 states over nine months
- The participants’ blood pressure was monitored at home four times a day for seven consecutive days
Eris Lifesciences commissioned the India Heart Study, conducted under the aegis of Batra Hospital and Medical Research Centre.