Hypertension: A silent killer is on the prowl. Are your defences ready?


Do you fall in 20-35 age group? If yes, when was the last time you had your blood pressure checked?

In all likelihood, you either shrugged the idea off as unnecessary because you feel you are in fine fettle, put it off to some other day, or just have not given a thought to it assuming that is something to do with the older people.

Gone are the days when high blood pressure or hypertension was a problem affecting only middle-aged or old people. More than a billion people worldwide suffer from hypertension and according to WHO estimates, 7.5 million die annually from it.

Today, more and more youngsters, even in their twenties, are falling prey to hypertension, a condition also christened as the ‘silent killer’ as it is not something you feel or notice, it rarely manifests symptoms in the early stages and, ironically, most people go undiagnosed.

You appear to be totally healthy but it is not unusual if symptoms show themselves only after the condition has already caused serious damage to your vital organs. A survey carried out a few years ago in the Kathmandu valley by the Centre for Heart Attack Awareness showed that of the 1,443 people surveyed, 28 per cent between 18-40 years had hypertension.  What is most alarming is that the figures are escalating every year.

To get an in-depth understanding of this disease and to furnish the readers with first-hand knowledge and information from an expert, I decided to see a cardiologist, Dr. Denis Shrestha, MD, at Advanced Polyclinic, Pani Pokhari, Kathmandu.

The ambiance at the APC was one of welcoming and serenity, the good vibes accentuated by the soft music that was so soothing to the ears and the mind.  After only a few minutes of waiting, a nurse courteously ushered me into Dr. Denis’s cabin.

Dr. Denis has been in practice as a cardiologist for the last 20 years. After a warm handshake and a welcoming smile the doctor showed me to a chair and we began.

Is it true that more and more young adolescents today are diagnosed with hypertension?

Yes, that’s true. In the last two decades, the number of young people developing HBP (high blood pressure) or hypertension has gone up, mostly in urban areas.

I’d also like to include in this group those young migrant workers who return home after working in the gulf countries.

So, what are the causes of this proliferation of hypertension among younger people in the recent years?

Well, there are several causes and the prime ones are: sedentary lifestyle with no physical exercise, overeating, instead of eating healthy food indulging more in starchy junk food, mental stress, and reasons of heredity (through the genes).

What exactly is blood pressure? 

In simple terms, blood is a medium of transport for oxygen and all other nutrients our body cells need. It also serves as a channel to get rid of the waste produced by the cells.

In order for the blood to flow from one place to another, a pressure is required. To explain in simple words, like you pump up water into your reserve tank at home, the heart in the same manner acts as a mechanical device to generate this pressure to pump the blood around the body. This pressure is called BP.

What should be the BP reading of a normal person, both young (18-30 years) and old (40-60 years and above)?

Generally the widely accepted or ideal and healthy BP reading is: systolic: 120 mmHg and diastolic: 80 mmHg, referred usually as 120/80. Fluctuations may occur, but the reading should not exceed 140/90. For older people (55-60 years and above), up to 150/90 is acceptable for healthy individuals without a history of diseases such as, diabetes, heart disease and kidney problems.

How often should young/old people get their BP checked?

Normal healthy people, young/old, should check their BP at least once a year and every time they visit a clinic for other reasons (like, fever, infections or annual health check-ups).

What exactly does a systolic and diastolic pressure mean?

Whenever the heart contracts, it squeezes the blood out. The pressure generated by the heart is called systolic, a derivative of the Latin word “systole”. When the heart is relaxing, the remaining pressure in the blood vessels is known as diastolic, “diastole” in Latin.

At what stage the BP reading is regarded as high?

If three readings of BP exceed 140/90, the case is ruled as HBP (high BP) or hypertension and the doctor prescribes treatment.

Are there different kinds of hypertension?

Yes, hypertension is of two types. They are: the Essential or Primary hypertension and the Secondary hypertension.

In the case of essential or primary hypertension, almost 90 to 95 per cent individuals have no symptoms and the causes are generally attributed to obesity, excessive alcohol intake, smoking, sedentary lifestyle, high salt intake and heredity.

The causes of secondary hypertension can be several, such as, kidney disease, kidney stone, tumor of the adrenaline producing gland, narrowing of blood vessels that supply blood to the kidneys, hormonal imbalance and drugs like cocaine.

What are the serious complications of hypertension?

The complications of hypertension can be two-fold:

  1. Immediate: resulting in stroke, paralysis and death
  2. Chronic: leading to kidney failure, blindness, heart attacks and death

What are the preventive measures for hypertension?

The best and dominant medicine for HBP or hypertension is EXERCISE.  Regular exercise (say a regimen of 5 days a week), which makes you sweat out and get breathless is recommended. A simple brisk walk and a moderate jogging can make a world of difference. What’s more—it’s free!

Try staying away from junk or fatty food and avoid excessive intake of salt.

If you are overweight, try to lose weight.

Eat more vegetables and fruits and learn to cope with stress—yoga and meditation help.

If the BP reading persists, you have to go for medication.

“I always remind my patients, both aged and young, to stick to a regular exercise to keep this disease at bay. I also tell them that if everyone did a regular workout, followed by a healthy food habit, I’d soon run out of my business,” added Dr. Denis with an amusing smile.  I, too, could not restrain from grinning back at the doctor’s good sense of humor. With that the interview wound up.

Hey young fellas, hang on a one second! My latest research also led to a new finding, which I think you should know. Hypertension if not addressed on time may also be a cause of ED—that’s erectile dysfunction (“Erectile dysfunction is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence”). So, take care!


Singh is a 65-year-old outdoors man, lost in his own little adventures. Interests?  It used to be hunting; it stopped during the Maoist insurgency. Then came fishing followed by mountain biking. So, his passions are writing, mountain biking and fishing. Ambition?  Ride his mountain bike from Beni, Baglung, to Lo Manthang and Upper Mustang.

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Ravi M Singh is 68. After college, he got into business, all sorts—from chicken feed, furniture, catering to real estate. It worked for some time, but eventually, he gave it up all.

“Looking back, it seems I’ve always been an outdoorsman, lost in his own little adventures. My, interests?  It used to be hunting; it stopped during the Maoist insurgency. Then came fishing followed by mountain biking. So, my passions are writing, mountain biking and fishing.”

“I had the ambition to ride my bicycle to Lo Manthang, Upper Mustang. I dreamt about it. Finally, I did it in November 2018. I have not set any goal for the oncoming years. Who knows, the Thorong Pass, Manang, could be my next? I leave that to my Karma.”

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