As many as 42 percent of Indians could be at risk of having their blood pressure misdiagnosed, suggests research published earlier this week.
The Indian Heart Study, which researchers promoted in Mumbai, found there to be a relatively high prevalence of both ‘masked hypertension’ and ‘white-coat hypertension’ in a study of 19,000 people. White-coat hypertension, or white-coat syndrome, refers to when someone’s blood pressure is heightened due to the anxiety of being in a medical facility. Masked hypertension, meanwhile, refers to when an individual’s blood pressure reading is within a healthy range during their initial examination but elevated at other times.
The study found that 24 percent of those surveyed presented with white-coat hypertension, whilst eighteen percent presented with masked hypertension. Both are higher than the global average: white-coat hypertension affects between ten and fifteen percent of people worldwide, whilst masked hypertension affects between eight and twelve percent.
The findings are worrying for Indians, given that white-coat hypertension and masked hypertension are both associated with a higher risk of sustained hypertension than those with normal blood pressure levels. White-coat hypertension has also been linked to an elevated risk of experiencing a heart attack or similar cardiac event, in addition to an increased risk of resultant mortality.
“[The] India Heart Study points to a need for better clinical management of hypertension in India,” said the study’s principal investigator and cardiologist Dr Upendra Kaul. “This is India-specific data and should help shape the best practices for the diagnosis of high blood pressure among Indians. The study presents exhaustive data on the various aspects of hypertension.”
Both white-coat syndrome and masked hypertension necessitate additional monitoring, to ensure that the most accurate diagnosis of an individual’s blood pressure can be made. In India, an estimated 244 million people live with hypertension and 10.8 percent of deaths can be attributed to the condition. In tackling the condition, awareness of white-coat syndrome and masked hypertension and treatment accordingly are essential in both diagnostics and should comprise part of government strategies such as the hypertension control drive recently launched by the Indian Council of Medical Research (ICMR). Awareness of the conditions is also important for individuals as well as practitioners, so that they can take note of their own blood pressure and mitigate risk factors which could increase their chance of becoming hypertensive themselves.