“I am slim, I walk daily, and I don’t eat much junk food. High blood pressure cannot happen to me, right?”
Cardiologists say this assumption is among the most dangerous myths surrounding hypertension today.
“Many people believe hypertension affects only overweight or physically inactive individuals. While obesity and sedentary lifestyles are important risk factors, high blood pressure is also influenced by genetics, stress, poor sleep, excessive salt intake, smoking, alcohol use and several underlying medical conditions,” Dr. Krishan Yadav, Senior Consultant – Interventional Cardiology, Yatharth Hospital, Noida, explained.
He warned that a growing number of lean and physically active individuals are being diagnosed with hypertension, often only after serious complications develop. “They should also routinely check themselves for hypertension.”
India today faces a mounting hypertension crisis. Nearly one in four Indian adults — an estimated 220 million people — is living with high blood pressure, making it one of the country’s leading contributors to premature mortality, heart attacks, strokes and kidney disease.
No wonder the disease that can be diagnosed within minutes and controlled with affordable medicines and lifestyle changes continues to claim millions of lives globally, exposing one of the world’s most persistent public health failures.
A major global analysis led by researchers at Tulane University and published recently too has found that hypertension remains a growing and deadly epidemic, with its burden rising sharply over the past two decades, particularly in low- and middle-income countries that are least equipped to manage it.
The study, published in the Journal of the American College of Cardiology, found that while the prevalence of high blood pressure declined modestly in high-income countries between 2000 and 2020, it increased substantially across low- and middle-income nations. Nearly 90% of the global rise in adults living with hypertension during this period occurred in these countries.
The findings underscore the widening global inequality in the diagnosis and management of one of the world’s leading causes of premature death.
Hypertension now affects nearly 1.7 billion adults globally — around one in every three adults — and is responsible for an estimated 10 million deaths each year.
“This study shows that urgent action is needed everywhere,” said Samantha O’Connell, lead author of the study and doctoral researcher at Tulane’s Celia Scott Weatherhead School of Public Health and Tropical Medicine.
“What was particularly striking was that awareness, treatment and control rates remain far below where they should be, not only in low- and middle-income countries but even in high-income nations.”
Often referred to as the “silent killer”, hypertension frequently progresses without symptoms until it triggers devastating complications such as heart attack, stroke, kidney failure or vascular dementia.
Even among those diagnosed, treatment often remains inconsistent due to poor follow-up, limited medication adherence, weak health systems and delays in adopting evidence-based treatment protocols.
The study found that in 2020, fewer than 20% of adults with hypertension worldwide had their blood pressure adequately controlled.
The disparity between wealthy and poorer nations remains stark. Blood pressure control rates stood at 40.2% in high-income countries, compared with only 13.6% in low- and middle-income nations.
“While some progress has been made, global hypertension control remains extremely low,” said Katherine Mills, senior author of the study and professor of epidemiology at Tulane University.
The study is among the most comprehensive assessments of global hypertension trends to date. Researchers analysed data from 287 population-based studies involving more than six million adults across 119 countries, examining trends in prevalence, awareness, treatment and control over two decades.
The study warned that the growing burden of hypertension places enormous financial strain on health systems already struggling with competing priorities such as infectious diseases, maternal healthcare and childhood illnesses.
The researchers said the findings reinforce the need for stronger implementation of proven interventions, including wider access to affordable medicines, accurate blood pressure measurement, standardised treatment protocols and team-based care models that support long-term management.
According to experts, only around 12% of people living with hypertension in India are able to maintain their blood pressure within recommended levels, leaving millions vulnerable to life-threatening complications.
The concern extends across the WHO South-East Asia Region, where more than 273 million people are estimated to be living with hypertension. Alarmingly, over 159 million remain unaware of their condition.
“Many people discover they have hypertension only after suffering a heart attack, stroke or kidney damage,” the global health body said in a recent statement, describing regular blood pressure monitoring as one of the most neglected preventive healthcare practices.
This year’s World Hypertension Day theme — “Controlling Hypertension Together: Check Your Blood Pressure Regularly, Defeat the Silent Killer” — seeks to reinforce the importance of early detection and coordinated public health action.
Prof. Rakesh Yadav, Cardiologist and Head of the Department of Emergency Medicine at the All India Institute of Medical Sciences (AIIMS), Delhi, said obesity continues to remain a major contributor to hypertension and cardiovascular disease but stressed that long-term prevention depends on sustained lifestyle changes.
“Regular monitoring of blood pressure and blood sugar, affordable lifelong medication, healthy dietary practices and weight management are essential to reducing deaths linked to hypertension and related illnesses,” he said.
