Hypertension in Young Adults: Understanding the Rising Health Concern

On a global scale, hypertension is third among six major risk factors for cardiovascular disease. The risk of heart disease, stroke (whether thrombotic or hemorrhagic), kidney renal failure and arrhythmia significantly increase due to hypertension. Adults who are obese, consume alcohol, smoke, chew tobacco, follow a sedentary lifestyle, consume excess salt and have unhealthy lifestyles are at greater risk of developing hypertension and complications associated with it. There are certain risk variables, such as ignorance about illnesses and a disregard for health. 

In the past several decades, hypertension in young adults (18-24 years) and middle-aged (25-44 years) has emerged as a serious health issue across the globe. It is one of the leading causes of death and disability due to rising prevalence. Approximately 9.4 million fatalities per year are attributed to hypertension worldwide. In India, 25-28% of adults suffer from hypertension. Due to the lack of severe symptoms and potentially fatal effects, it is known as a silent killer. Early screening and treatment are the most important preventive steps. 

Though hypertension in young adults is less than in middle-aged individuals, early diagnosis can prevent long-term complications later in life. Screening should also be done to look at additional risk factors such as diabetes, lipid abnormalities, and more. If diagnosed early, hypertension can be reversed by lifestyle intervention. Heavy salt diet, excess body fat, lack of exercise, inadequate consumption of fruits and vegetables and excessive alcohol consumption, all increase the risk to many folds. Frequent smoking is a further complicating factor. 

*The risk of developing hypertension was reduced by 70% in those who gave up alcohol. Regular exercise, regular checkups and regulated diets are also key to having normal pressure. Family history of hypertension and (BMI) body mass index above 30 kg/m2 are strong predictors of hypertension. Those who eat 10 gms of salt per day are at very high risk. 

Two major risk factors, especially among young hypertensive, are smoking and alcohol intake. In one global study, 88% smoked cigarettes and 54% drank alcohol. Diet, especially fast food, which is loaded with unsaturated fat and high salt content, is also a culprit in this age group. The diet is usually poor in proteins and carbohydrates, with a high content of unhealthy unsaturated fats. Inadequate sleep, using too much of electronic gadgets, and prolonged sitting are also health hazards. Approximately 25% of hypertensive individuals have a strong family history of hypertension. A very young hypertension patient must be screened for secondary hypertension like reno-vascular hypertension, coarctation of the aorta, and Cushing's syndrome, which require a high index of suspicion.

To summarize, hypertension is becoming very common in young individuals. Having a good quality diet, low in salt intake, avoiding trans fats, a good intake of fresh fruits and vegetables, low-fat dairy products, avoiding hurry, curry and worries, prolonged sitting, lack of adequate sleep and water intake, no smoking and tobacco use and quitting alcohol, with a proper screening at the early age, can prevent the silent killer before it causes morbidity and fatalities. Rising pollution, urban congestion, traffic hazards, and four Ps (plastic, preservatives, pesticides and polluting chemicals) further complicate the situation. Screening, educating, and targeting high-risk populations can benefit the spread of awareness.