India is getting ready to hit a $5 trillion economy soon. But the health of its citizens has become a matter of urgent concern. Over the past several years, there has been a rise in non-communicable diseases (NCD) in the country. NCDs are diseases that are not transmitted through infections or from other people, but are typically caused by unhealthy behaviors or other factors. Common examples are diabetes, hypertension, heart disease, stroke and cancers, and chronic respiratory diseases (such as COPD and asthma). It is estimated that NCDs kill approximately 5 to 6 million Indians each year. The good news, however, is that NCDs are largely preventable. By modifying risk factors, we can reduce our risk.
What is hypertension?
Hypertension, a major non-communicable disease, is responsible for a significant number of global deaths, approximately 17.9 million yearly. The Global Burden of Disease 2019 (GBD 2019) estimates that 19% of global deaths are attributed to elevated blood pressure.
Our heart beats approximately 1,00,000 times a day and when it pumps blood into the arteries – the blood pipes that carry blood to various parts of the body—pressure is generated. This pressure is known as blood pressure. A blood pressure reading has two numbers: the number on top is systolic, and the lower number is diastolic. The upper limit of normal for the systolic number is 140 mm/Hg, and for the lower one is 90 mm/Hg.
Hypertension in India
As per National Family Health Survey – 5 (NFHS-5) data from 6,36,699 households across all States and Union Territories, the overall prevalence of hypertension in India was found to be 22.6%: men (24.1%) had a higher prevalence than women (21.2%). Interestingly, the data noted that some States including Punjab, Kerala and Karnataka had a higher prevalence of hypertension, while it was low in Rajasthan, Gujarat and Assam.
A 2023 study on hypertension diagnosis, treatment and control in India found that nearly 2 in 3 persons with hypertension remained undiagnosed, across all States, both in urban and rural areas. Among those with a diagnosis, only half were treated; treatment rates were higher in southern and western India and lower in other parts of the country. Among those treated, nearly half did not have their blood pressure under control. Cumulatively, more than 90% of adults with hypertension in India were either undiagnosed, untreated, or treated but remained with uncontrolled hypertension.
Measuring blood pressure
The American Heart Association (AHA) has issued guidelines for the measurement of blood pressure at home. These include: planning your BP measurement; not smoking or drinking caffeinated beverages or exercising within 30 minutes before taking your blood pressure; emptying your bladder; and removing the clothing over the arm that will be used to measure blood pressure. Either arm can be used; there is usually not a big difference between readings on them. While measuring BP, be still and allow at least five minutes of quiet rest before measurements. Don’t talk or use the phone. Sit correctly; sit with your back straight and supported (on a dining chair, rather than a sofa); your feet should be flat on the floor and do not cross your legs. Support your arm on a flat surface. The middle of the cuff should be placed on the upper arm at heart level. Check your monitor’s instructions for an illustration or have your health care professional show you how. Measure at the same time every day.
Talk with your health care professional about how often to take your blood pressure. Take multiple readings and record the results. Each time you measure, take two readings one minute apart.
The AHA recommends an automatic, cuff-style, upper arm (biceps) monitor. Wrist and finger monitors are not recommended as they give less reliable readings. It is recommended that you take this machine to your doctor and see if you are taking the readings correctly.
Targets for blood pressure control
The AHA and American College of Cardiology (ACC) guidelines recommend a target of less than 130/80 mmHg for most adults. The European Society of Cardiology (ESC) guidelines also recommend a target of less than 130/80 mmHg for most patients. Your doctor may perhaps modify this number to a higher or lower one based on the clinical situation. And so, it is important to check with your doctor what the blood pressure goal for you is.
The following steps are recommended to control blood pressure.
Lose weight and watch your waist line: If you are overweight, a drop of 1 to 2 kg can decrease your BP by 1 mm of Hg. Men with waistlines of over 40 inches and women with over 35 inches are at risk of developing high blood pressure.
Exercise regularly: Exercise brings the blood pressure down by 4 to 8 mm of Hg. It is recommended that we exercise for 30 minutes a day, five days a week.
Decrease salt in the diet: One simple way to cut down on salt intake is to avoid adding salt at the table while eating. Processed food products and items such as pickles and pappads contain a lot of salt; it is better to avoid them or have them in moderation.
Quit smoking: Smoking raises blood pressure levels. Quitting smoking has the added benefit of reducing the risk of heart attacks and lung cancer as well.
Get a good night’s sleep: Adults should aim to get 7 to 9 hours of sleep daily. Go to bed and wake up at the same time each day. Have a light meal close to bedtime and avoid being on the mobile phone till you sleep.
The government’s role
The Indian Hypertension Control Initiative (IHCI) is a five-year initiative involving the Ministry of Health & Family Welfare, Indian Council of Medical Research, State governments, and the World Health Organization – India. It was launched in November 2017 and by 2020, 10 States and 52 districts were covered. The aim was to reduce the hypertension burden by 25% by 2025. The initiative has given broad guidelines on which drugs to start and follow up on.
In India, more than 1 in 4 people have hypertension, and cumulatively, more than 90% of adults with hypertension are either undiagnosed, untreated, or treated but live with uncontrolled hypertension. This burden needs to be tackled on an urgent basis to help ensure a healthy future for the country.
This article was first published in The Hindu’s e-book Care and Cure
(Dr. V. Jacob Jose is consultant cardiologist at Naruvi Hospitals, Vellore. jacobjose.v@naruvihospitals.com Dr. K. Suresh Kumar is consultant interventional cardiologist at Naruvi Hospitals, Vellore. sureshkumar.k@naruvihospitals.com)
Published – January 12, 2026 04:54 pm IST