01/7Hypertension risk in India
The global burden of hypertension as a risk factor for several fatal diseases has been well documented by experts and scholars for decades. In fact, it is the leading cause of cardiovascular disease worldwide and accounts for at least 10 million deaths annually, according to the World Heart Federation. While the same report showed that 1.3 billion people globally were affected by hypertension, there are indications that India is one of the world’s epicentres for hypertension.
02/7Here’s what the study says
According to the World Health Organisation, India has set a target of 25% to reduce the prevalence of hypertension (high blood pressure) by 2025. Thus, to accelerate access to treatment services for over 220 million people in India who have hypertension, the government of India has launched the Indian Hypertension Control Initiative (IHCI). WHO further highlights that only about 12% Indians with hypertension have controlled blood pressure.
Several studies have shown that Indians are more susceptible to hypertension at a younger age than people from other parts of the world like Europe, and a number of factors, including lifestyle changes, comorbidities, tobacco use, alcohol intake, dietary patterns, as well as ethnicity and high salt intake, the latter two of which are the focus of this article.
03/7Why is Indian ethnicity linked to hypertension?
Sanjeev Jain, Jt. managing director, Akums Drugs and Pharmaceuticals says, “One may wonder how ethnicity plays a role in hypertension, but it’s easy when one considers the many components that make up an ethnic group. First, an ethnic group— no matter how large— has a common progenitor (or at least closely related ancestral history). Science has shown that high blood pressure is hereditary and can move from generation to generation. This is why family history is a huge risk factor for hypertension. Hence, it is likely that hypertension has run through many generations in India and continues to do so today.”
Another possible explanation is the fact that people from the same ethnicity tend to have similar lifestyles, diets, and habits, which may pose a risk factor for high blood pressure. On the other hand, India has undergone tremendous cultural, lifestyle, and demographic changes in recent years which may also be responsible for changing health patterns and impacting the health of Indians more negatively. An increasing intake of alcohol and junk-fatty-preserved foods, especially among urban millenials and Gen Zs is a case in point.
04/7The nexus between salt and hypertension in India
“High intake of sodium has been found to cause high blood pressure in people, and at least 90% of sodium consumed by humans is found in salt. The science is simple; with high salt intake, salt level in the bloodstream increases and this attracts water, which then increases the amount of blood in the vessels and raises the pressure because more blood needs to rush through. This tricky situation is why sodium levels in the bloodstream must be regulated at all times, especially through maintaining a healthy salt intake,” says Jain.
Several studies have found a higher prevalence of hypertension in countries and places where salt intake is higher. In India, this is also the case. Let’s consider some facts that show this trend. The daily salt intake for an average Indian today is between 10 and 11 grams, according to several studies. This is twice the amount recommended by the World Health Organisation for daily salt intake, which is a maximum intake of less than 2000 mg/day sodium (less than 5 g/day salt) in adults.
05/7Eating outside food also worsens the BP levels
Already, this puts a lot of Indians at risk of spiking blood pressure. Some analysts have attributed this high salt consumption to takeouts and high patronage of snacks and fast foods. Indeed, this is accurate. A study, conducted by the All India Institute of Medical Sciences (AIIMS) in association with the University of North Carolina at Chapel Hill (UNC), mentions that a huge chunk of ultra-processed foods found in the Indian food market contain multitude of additives, including excess salt and saturated fats. 10,500 products were analysed that had provided complete nutrition information in the nutrition facts panel. They found only 32% are within the limit, as per WHO’s regional standards. A few other surveys note that foods like papads and pickles are some popular accompaniments that have more than necessary sodium levels. Also, the food consumed as munchies—processed food or bakery items—has salt in various forms.
Aside from staying away from tobacco, excessive alcohol intake, eating right and exercising regularly, managing your salt intake is one way to avoid cardiovascular diseases and hypertension. Reducing the amount of takeouts and fast foods, cutting down on refined table salt consumption, and generally having a less-salt diet in line with WHO recommendations can go a long way to reduce the prevalence of hypertension in India.
07/7Use table salt alternatives
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