High Blood Pressure: How It Affects Your Heart and Ways to Control It

By Dr. (Prof.) Tarun Kumar, Senior Director – Medanta Moolchand Heart Centre, Cardiology

Introduction

High blood pressure (hypertension) is called the “silent killer” because it often has no symptoms until complications arise. Many patients visiting a private hospital in Delhi don’t realize they have hypertension until it damages their heart, brain, or kidneys. At Moolchand, one of the top hospitals in Delhi, our superb physicians deliver outcomes that matter—using cutting-edge diagnostics, compassionate care, and integrity-driven treatment plans at affordable prices.

How High Blood Pressure Affects the Heart

·       Damages Arteries: Causes narrowing, stiffness, and increases risk of atherosclerosis.

·       Increases Risk of Heart Attack: Promotes plaque buildup in coronary arteries.

·       Leads to Heart Failure: Continuous strain weakens the heart muscle.

·       Raises Stroke Risk: Affects blood flow to the brain, leading to ischemic or hemorrhagic stroke.

Updated Hypertension Recommendations (2025 vs 2017)

The latest international guidelines have updated how doctors should diagnose, evaluate, and treat hypertension. Key highlights:

Section

2017 Recommendation

2025 Recommendation

Terminology

Hypertensive urgency

Now referred to as Severe Hypertension

Secondary Hypertension

Not routine

Screening for primary aldosteronism is recommended in adults with resistant hypertension (even without low potassium).

Primary Aldosteronism Screening

Limited

Continue most BP medications (except MRA) before screening to avoid delays.

Lifestyle Approaches

General salt reduction

Potassium-based salt substitutes can be useful—except in CKD or when potassium retention is an issue.

BP Treatment Thresholds

Start meds if SBP ≥130/DBP ≥80 with 10-yr CVD risk ≥10%

Lower threshold: Start meds at ≥130/80 if risk ≥7.5% (PREVENT model) or in diabetes/CKD—even without clinical CVD.

Diabetes

ACEi/ARB may be considered if albuminuria present

ACEi/ARB are recommended if eGFR <60 or albuminuria ≥30 mg/g.

Chronic Kidney Disease

ACEi reasonable, ARB if ACEi not tolerated

RAAS inhibitor (ACEi or ARB) strongly recommended in CKD with albuminuria ≥30 mg/g.

Stroke (Acute ICH/Ischemic)

Lower BP cautiously >220 mmHg

Immediate but smooth BP control to 130–140 mmHg after ICH; avoid aggressive lowering post-reperfusion in ischemic stroke.

Cognitive Health

BP lowering “reasonable” to prevent decline

Target SBP <130 mmHg recommended to prevent dementia/MCI.

Pregnancy

Avoid ACEi/renin inhibitors

BP control <140/90 mmHg for chronic hypertension; SBP ≥160/DBP ≥110 must be treated within 30–60 min; low-dose aspirin advised to prevent preeclampsia.

Resistant Hypertension

Few recommendations

Detailed evaluation + multidisciplinary approach; renal denervation (RDN) considered in select patients.

Severe Hypertension (Non-emergency)

Acute IV drugs sometimes used

Not recommended in patients without organ damage; careful stepwise outpatient management preferred.

Ways to Control High Blood Pressure

1. Lifestyle Modifications:

·       Eat a diet rich in fruits, vegetables, and whole grains.

·       Use potassium-based salt substitutes where safe.

·       Exercise at least 150 minutes a week.

·       Maintain a healthy weight.

·       Quit smoking and reduce alcohol.

2. Medication Management:

·       ACE inhibitors, ARBs, calcium channel blockers, or diuretics depending on patient profile.

·       Tailored therapy for diabetes, CKD, or pregnancy as per new guidelines.

·       Monitoring by superb physicians at a trusted Delhi hospital ensures safety.

3. Regular Monitoring:

·       Home BP monitoring for early detection of spikes.

·       Periodic visits to specialists for dose adjustment.

Conclusion

Hypertension is no longer managed with a “one size fits all” approach—the 2025 recommendations emphasize personalized care, early screening for secondary causes, lifestyle interventions like potassium salt, and tighter thresholds for high-risk groups.

At Moolchand, among the best hospitals in India, patients trust us for compassionate care, integrity-driven treatment, cutting-edge technology, superb physicians, and affordable prices. Managing blood pressure early not only protects the heart but also prevents kidney disease, stroke, and dementia.

By Dr. (Prof.) Tarun Kumar, Senior Director – Medanta Moolchand Heart Centre, Cardiology