Managing hypertension during monsoon: Doctors advise against salty, fried snacks despite seasonal temptations

Though delayed by a month, the monsoon recently arrived in full swing, bringing delicious recipes to our social media explore pages.

Deep-fried pakoras, samosas, sweet-spicy chaats, namkeen, and farsan with chai, as well as dal-chawal with a dollop of pickle and crunchy, salty papads, are some monsoon staples. They come with opportunities to miss the gym on heavy rainfall days and cosy up indoors for hours.

But have you thought about how these can spike your blood pressure levels? Three experts weighed in to elaborate on this and much more about hypertension. High blood pressure is a rather normalised condition in most Indian households.

In the first-ever WHO report on hypertension in India, published last year, it was revealed that 188.3 million people in the country were living with the condition, but only 37% of these were aware of their status. Another study by ICMR in March 2024 highlighted that 1 in 3 Indians suffers from hypertension.

Hypertension, commonly known as high blood pressure, is a condition in which the blood pressure in the arteries is elevated. A reading of 140/90 mmHg or higher is considered hypertension.

Though the condition was more commonly seen in men than women by 60-65% in the age group above 40 and those with a sedentary lifestyle, doctors say that these parameters are now changing.

Trends with changing times
Life after the Covid-19 pandemic has been full of changes. Businesses switching to hybrid or remote operations, the rise of Ed-Tech, the high penetration of instant home delivery apps, and our growing addiction to being constantly online have all contributed to a sedentary lifestyle.

While hypertension was usually associated with ageing, doctors now suggest that everyone, regardless of age, must monitor their blood pressure. "In the last five years since the pandemic, we have observed that people in their early 30s and even chilen suffer from hypertension due to the rise in sedentary lifestyles leading to obesity," says Dr Prashant Pawar, Consultant-Cardiology at Fortis Hiranandani Hospital in Vashi.

Some commonly known causes of hypertension are high sodium intake, an inactive lifestyle, obesity, drug abuse, and excessive alcohol consumption. However, doctors reveal that hyperthyroidism and kidney disorders, such as stones, are also linked to hypertension. Additionally, having a family history of the condition can also make one prone to hypertension.

"Jobs with high-stress levels and long working hours can put a strain on your heart, resulting in high blood pressure," says Dr Anand Ram, Consultant Interventional Cardiologist at Wockhardt Hospitals in Mira Road.

Blood pressure and mental health
Stress and blood pressure are closely intertwined. Dr Anand explains that when your body experiences stress, it enters into fight or flight mode, a normal response triggering the release of hormones like adrenaline and cortisol. Adrenaline, in particular, can strain the heart, causing it to beat faster and narrowing blood vessels, thereby spiking blood pressure levels.

In addition to these acute spikes, Dr Prashant highlights that prolonged mental health issues such as stress, depression, and anxiety can gradually contribute to hypertension over months and years. "Mental health issues not only lead to hypertension, but hypertension can also worsen mental health. It's a two-way relationship," he said.

Dr Irfan Khan, Interventional Cardiologist at Dr LH Hiranandani Hospital in Powai, adds that poor mental health often correlates with poor dietary choices, irregular sleep patterns, an inactive lifestyle, and even substance abuse, among other factors. These can collectively contribute to elevated blood pressure levels. Therefore, addressing mental health is crucial in managing hypertension effectively.

Hypertension - a silent killer
What's not known to many is that hypertension is asymptomatic and hence called a Silent Killer. According to Dr Prashant, it affects vital organs like the brain, kidneys, and lungs, gradually damaging them over time without any visible signs in the initial stages. This underscores the importance of routine check-ups.

Dr Prashant lists some serious health complications caused by hypertension, including heart attack, stroke, brain haemorrhage, kidney damage, peripheral artery damage, and dilatation of the aorta (the body's largest artery that carries blood from the heart to the circulatory system).

Though hypertension is typically asymptomatic, doctors advise monitoring for symptoms such as severe headaches, dizziness, difficulty breathing, lack of energy, sharp chest pain, irregular heartbeat, and nosebleeds.

Common myths
A recent study published by the Indian Council of Medical Research revealed that nearly 3 out of 10 people aged between 18 and 54 have never had their blood pressure checked. This highlights a hesitancy towards routine blood pressure check-ups. Doctors suggest that some myths may contribute to this hesitance.

A common myth, shared by Dr Prashant, is that people often normalise high blood pressure. "Patients may say that their blood pressure is always high and has never affected them, so there is no need to check it regularly." However, since hypertension is asymptomatic in most cases, people may neglect routine blood pressure checks. Dr Prashant advises otherwise, emphasising the importance of regular check-ups and monitoring blood pressure levels.

Meanwhile, another reason routine check-ups are avoided is because people fear that once high blood pressure is diagnosed, they'll be prescribed lifelong medications and may have to endure side effects.

"A lot of people think that only lowering their salt intake will help in managing their blood pressure," says Dr Anand, discussing common myths associated with hypertension. He emphasises that a low-sodium diet combined with an active lifestyle is key to effectively managing hypertension.

Navigating hypertension
At least 4.6 million deaths in India could be prevented by 2040 if half of the people with hypertension manage to keep their blood pressure under control, according to the first-ever report by the World Health Organization on the global impact of the condition.

There is no quick fix for hypertension. It requires a slow and gradual journey of making lifestyle changes that eventually become habits.

The average Indian diet is known for its high sodium content. According to the World Health Organization (WHO), India ranks among the top 50 countries with high salt consumption. The recommended daily intake of salt is 5 grams per person, but studies indicate that Indians often consume more than 10 grams per day.

"Beloved food items like pani puri, farsan, papad, pickles, biscuits, etc., have high sodium content, which can spike blood pressure levels," says Dr Prashant. He suggests considering eliminating these items from one's daily diet. Additionally, while salt and pepper shakers are common on dining tables, Dr Prashant advises removing them when attempting to lower salt intake.

He further advises adopting a high-fibre and potassium-rich diet while avoiding monsoon delicacies. "Seasonal fruits and vegetables should be added to the diet, such as jamun, apples, plums, peaches, bottle gourd, bitter gourd, Indian squash, and green leafy vegetables," he says.

As the Indian palate is accustomed to certain salt levels, Dr Prashant suggests considering options like low-sodium salts, Himalayan salt, or rock salt. "Himalayan salt is high in potassium, which is beneficial for the body while being lower in sodium," he explains.

Though reducing salt intake can significantly impact health, it alone may not suffice. Dr Anand recommends incorporating deep breathing exercises and light exercises into daily routines. "Engaging in deep breathing exercises for over 5 minutes daily can relax blood vessels, temporarily reducing blood pressure levels by mitigating hormones such as adrenaline," he explains.

"Going to the gym or engaging in intense workouts isn't necessary," says Dr Prashant. "A daily 30-minute walk is sufficient to stay active."

Monsoons can disrupt outdoor workout routines such as cycling, swimming, or running," explains Dr. Anand, explains Dr Anand. "In such situations, I recommend home workouts like power yoga, aerobics, Zumba, or dancing."

When discussing long-term solutions for hypertension, Dr Irfan stresses the importance of maintaining a healthy weight, keeping the body mass index in the healthy range, and regularly consulting with a doctor regarding any necessary prescriptions. Dr Prashant also emphasises the significance of routine checkups and encourages seeking medical advice promptly if any irregularities are detected.

As the monsoon settles in and brings cravings for fried, salty snacks and staying indoors, it's crucial to opt for healthier choices to prevent the gradual onset of hypertension. Regular checkups combined with an active lifestyle can be truly life-saving.