Around 1.13 billion people across the world suffer from increased blood pressure or hypertension, according to the World Health Organization. In India, nearly every one in four men and one in five women have elevated blood pressure or are currently taking medication to control their blood pressure, showed the National Family Health Survey (NFHS) 2019-21.

Hypertension is a serious health condition in which a person's blood vessels have persistently raised pressure. It is the number one contributing risk factor for premature death globally, according to International Society for Hypertension's statistics. Even then, experts say that almost half of all people affected by this disease are not aware of their condition.

According to the WHO, the number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with the increase seen largely in low- and middle-income countries.

Despite its increasing prevalence, many facets of hypertension are still misunderstood. FactChecker spoke to cardiologists to debunk some of the common misperceptions about the disease.

Myth 1: Youngsters don't have hypertension

Fact: Traditionally people aged over 40 were assumed to be more prone to hypertension due to thickening of blood vessels with age. But, recently, due to multiple factors such as our diets, sedentary lifestyle, and increased stress levels, the risk for the younger population is at an all-time high.

Dr GR Kane, cardiologist at PD Hinduja Hospital and MRC, Mahim, told FactChecker that young people are not immune to hypertension, especially if they are smokers, obese, or have both parents with a diagnosis of high blood pressure.

Almost 8 crore people in the 18-40 age group have high blood pressure, according to the Great India BP Survey conducted by the Cardiological Society of India (CSI). The research noted that less exercise and traditional diets that are high in salt content may be the cause.

Myth 2: Hypertension is genetic and does always get inherited

Fact: Genes are likely to play some role in high blood pressure, according to the CDC. However, it is also likely that people with a family history of hypertension share common environments and other potential factors that increase their risk such as smoking and eating an unhealthy diet.

Speaking about hereditary tendencies of hypertension, Dr Partha Sarathi Banerjee, CSI President and Chief Interventional Cardiologist, Manipal Hospital, Kolkata, said, "If factors like family history, obesity, diabetes, high cholesterol, obstructive sleep apnoea, alcohol abuse or frequent smoking are involved, one should get their blood pressure tested twice in every six months." This will ensure timely detection of hypertension and adequate treatment.

Myth 3: Blood pressure is high when it's above 140/90 mmHg

Fact: 140/90 mmHg is the criteria for hypertension diagnosis only when the healthcare setting is the physician's office or clinic, according to the new guidelines from International Society for Hypertension. In a home reading, the diagnosis threshold is 135/85 mmHg.

The 24-hour average ambulatory reading must be lower than 130/80 mmHg, the guidelines state.

Myth 4: Blood pressure rise is common and not a matter of concern

Fact: Though hypertension is becoming increasingly common worldwide, it is quite dangerous if it is not detected and treated in a timely manner. There are several serious risks associated with persistent and uncontrolled high blood pressure, such as kidney damage, heart attacks, strokes, haemorrhages, and cognitive decline.

Certain modifiable factors such as a balanced diet, regular exercise and healthy sleep patterns can go a long way in preventing it. Quitting tobacco, limiting one's intake of alcohol and sugar are some other ways in which one can significantly reduce their chances of developing hypertension.

Myth 5: Once on medication, patients can skip exercise

Fact: Medicines can't cure high blood pressure, they can only control it. Lifestyle changes (reducing salt intake, reducing stress and getting enough exercise) can make the blood pressure fall to some extent when combined with appropriate medication, clarified Dr Vishal Rastogi, Director of Cardiology at Fortis Escorts Heart Institute, Delhi.

"If hypertension is in the early stages or not very high to begin with, it is possible that medication is lowered over time and eventually stopped. But this can only happen if the patient has been making the prescribed changes to their diet and routine," said Dr Rastogi.

A number of studies have consistently demonstrated beneficial effects of exercise on hypertension, with reductions in both systolic and diastolic blood pressure to the tune of 5–7 mmHg in people with hypertension. Getting adequate sleep (7 or more hours) has been linked to a lesser likelihood of developing several heart ailments, including hypertension.

Myth 6: Medication can be stopped once blood pressure stabilises

Fact: If your blood pressure is controlled by medicines, in no event should you stop taking them without your doctor's advice, cautioned Dr Banerjee. In some cases, he added, your doctor might adjust your dose according to the fluctuations in your blood pressure levels.

While the effect of medicines may last over weeks, blood pressure is very likely to rise again. Since its symptoms are silent, it can damage vital organs like the heart, brain, and kidney. Skipping medicines can lead to irreversible organ damage.

Dr Kane told FactChecker that generally, hypertension treatment is lifelong. "Very few individuals may be lucky to get rid of medications, especially if their hypertension is mild. The medication normally may go down if lifestyle changes are effectively implicated," he said.

Myth 7: No blood pressure check is warranted in absence of symptoms

Fact: If one's blood pressure has increased gradually, the body adapts to it and usually there are no overt signs of the disease, said the experts.

It is only when the blood pressure is uncontrolled or severely elevated (>= 160 mmHg systolic and/or >=100 mmHg diastolic), do symptoms such as headaches, irritability, changes in vision, and pounding sensations appear. It is thus advisable to proactively monitor one's blood pressure, cautioned Dr Rastogi.