From the Research
Hypertension in Indians is classified based on blood pressure readings, with normal blood pressure being less than 120/80 mmHg, elevated blood pressure ranging from 120-129 systolic and less than 80 mmHg diastolic, Stage 1 hypertension defined as 130-139 systolic or 80-89 diastolic, and Stage 2 hypertension defined as 140/90 mmHg or higher. The classification of hypertension is crucial in determining the risk of cardiovascular disease and guiding management decisions. According to the evidence, Indians may develop hypertension at lower thresholds due to genetic predisposition, higher salt sensitivity, and increased prevalence of metabolic syndrome 1.
Key Classification Points
- Normal blood pressure: less than 120/80 mmHg
- Elevated blood pressure: 120-129 systolic and less than 80 mmHg diastolic
- Stage 1 hypertension: 130-139 systolic or 80-89 diastolic
- Stage 2 hypertension: 140/90 mmHg or higher Management of hypertension in Indians should begin with lifestyle modifications, including reduced salt intake, increased physical activity, weight management, and limited alcohol consumption 2.
Lifestyle Modifications
- Reduced salt intake: less than 5g daily
- Increased physical activity
- Weight management
- Limited alcohol consumption Medication is typically initiated at Stage 1 hypertension if cardiovascular risk is high or at Stage 2 regardless of risk factors 3.
Medication Initiation
- Stage 1 hypertension with high cardiovascular risk
- Stage 2 hypertension regardless of risk factors Regular monitoring is essential, with home blood pressure monitoring recommended to account for white coat hypertension, which is common in the Indian population 4.
Monitoring
- Regular blood pressure monitoring
- Home blood pressure monitoring to account for white coat hypertension The choice of antihypertensive medication should be based on the individual's risk factors and comorbidities, with angiotensin receptor blockers (ARBs) being a suitable alternative to angiotensin-converting enzyme (ACE) inhibitors due to their similar efficacy and lower risk of adverse events 5.
Antihypertensive Medication
- ARBs as a suitable alternative to ACE inhibitors
- Choice of medication based on individual risk factors and comorbidities