Dr. Rahul Gupta, Cardiologist, Apollo 24|7, has 18 years of experience in his field. Having completed MBBS from Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur (2000), MD (General Medicine) from University of Mumbai, Mumbai, Maharashtra (2006) and DM (Cardiology) fromTopiwala National Medical College, Mumbai (2009), he has been honoured to recieve prestigious awards throughout his career including the “Shankar Dayal Sharma Gold Medal” representing King Edward Memorial Hospital, Mumbai, Shri Salebh Bhai Ali Wali Gold Medal for scoring highest percentage of marks In Pharmacology and Young Scholar Award for Zonal Round First Winner.
High blood pressure, also referred to as hypertension, is the leading cause of mortality globally. It serves as a prominent risk factor for cardiovascular problems, especially stroke and ischemic heart disease. Over the last few decades, the prevalence of hypertension has grown significantly in India. As per the data collected by India’s Ministry of Health and Family Welfare, hypertension is responsible for 5% of disability-adjusted life years (DALY) and 11% of all deaths in the country. Moreover, the prevalence of hypertension in India is only expected to multiply by 2025.
Despite the substantial improvement in the treatment and awareness rates of hypertension witnessed by India in recent years, the number of cases of untreated and undiagnosed hypertension still serves as a major public health concern faced by the country. Notably, according to several studies, a higher prevalence of hypertension has been documented in urban areas at 47% as compared to rural areas, which stand at 26%. Furthermore, high blood pressure accelerates bone ageing, making the urban Indian population more susceptible to developing osteoporosis and suffering fragility fractures.
The question is, what makes urban Indians more prone to hypertension? And how does hypertension impact your bone health? Read on to find out.
Why is Hypertension More Prevalent in Urban Indian Population?
The number of hypertension cases has increased nearly 30 times in the urban Indian population in 55 years. Rapidly growing urbanisation has led to several socio-developmental changes over the last 4-5 decades. The dramatic lifestyle changes and massive technological advancements have resulted in the prevalence of physical inactivity. In addition to this, urban people also indulge in unhealthy diets loaded with sugar, fat, and calories.
These lifestyle choices lead to obesity, which eventually causes uncontrolled hypertension despite treatment. Studies show that those with higher BMIs are at an increased risk of developing stage I and stage II hypertension. As compared to individuals with a BMI of 18.4 or lower, those with a BMI equal to or higher than 25.6 were nearly 2.5 times more likely to develop stage I hypertension and about three times more at risk for stage II hypertension.
Why is Bone Ageing More Prevalent in Urban Indian Population?
As discussed above, multiple factors have contributed to the higher prevalence of hypertension amongst urban Indians. To add to it, in a recent study, a team of researchers found that high blood pressure can cause osteoporosis-related bone damage and bone loss. This lab study involving rats discovered that as compared to the young mice with normal blood pressure, the ones with induced hypertension showed a considerable 24% decrease in bone volume fraction. These young mice with high blood pressure also showed a reduction of 18% in spongy bone thickness. The study also discovered a 34% decrease in bone strength of the mice induced with high blood pressure, indicating their inability to withstand various types of force. On the other hand, older mice infused with the angiotensin-II (high blood pressure medication) did not show similar bone loss.
The study suggested that hypertension was adjusting the process of bone remodelling towards bone loss rather than bone equilibrium or bone gain. Consequently, bones will be weaker, which will lead to a higher risk of fragility fractures and osteoporosis.
Both hypertension and osteoporosis are quite common health conditions affecting the urban Indian population. With many people suffering from both problems simultaneously, it is safe to say that people with high blood pressure should also be screened for osteoporosis.
