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Silent killer alert: Nearly 20 cr Indians have high BP, renal denervation therapy offers new hope
With nearly 20 crore adults in India estimated to be living with hypertension and only about 2 crores managing to keep it under control, the condition has emerged as one of the country's most pressing public health concerns.
Medical experts have warned of the rising prevalence of resistant hypertension and highlighted the role of renal denervation (RDN), an advanced therapy showing promising results in managing uncontrolled cases.
A growing health concerns
Data from the National Family Health Survey (NFHS) shows that hypertension prevalence ranges from 16% to over 25% in some states, with urban areas reporting a higher share of patients whose blood pressure remains uncontrolled despite treatment.
In Delhi, prevalence is estimated at 28%. Experts note that about 5–10% of hypertensive patients in India may suffer from resistant hypertension, defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs.
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Resistant hypertension can progress gradually, presenting with symptoms such as frequent headaches, dizziness, breathlessness or chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs. Studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of heart disease by 20% and stroke by 27%.
What is Resistant hypertension
Resistant hypertension defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs is an under-recognized contributor to this challenge, affecting patients' long-term health and wellbeing. As per National Family Health Survey – 5, hypertension prevalence in Delhi is estimated to be 28%. Estimated 5-10 % of hypertensive patients in India are resistant, based on clinical practice.
Resistant hypertension may progress gradually, with symptoms such as frequent headaches, dizziness, breathlessness, or occasional chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs. Average BP reduction seen in patients treated in clinic; observed improvement in cardiovascular risk profile. Clinical studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of heart disease by 20% and stroke by 27%.
25 per cent average BP reduction with Renal Denervation
Dr Praveen Chandra, Chairman, Cardiology, Medanta (The Medicity) said 'While antihypertensive medicines are highly effective for many, control remains difficult for a significant number of patients. When patients understand their condition and the options available, they are better equipped to take control of their health and work with their doctors towards better outcomes.'
Renal Denervation: Hypertension solution
Renal Denervation is an advanced therapy that is minimally invasive, catheter-based procedure that addresses one of the underlying drivers of hypertension, overactive nerve signals between the brain and kidneys, Dr Chandra said, adding that by interrupting these signals, RDN helps lower and stabilise blood pressure over time.
'As per my experience, till date; 25% average BP reduction has been achieved in these patients; with a significant reduction seen in medication load post-procedure.'
Hypertension and kidney disease closely linked
'Uncontrolled hypertension is associated with multiple risk factors, including chronic kidney disease. Hypertension is very common in patients with CKD and CKD is the most important cause of resistant hypertension. Uncontrolled hypertension can cause rapid progression of kidney disease leading to kidney failure,' said Dr Shyam Bansal, Vice Chairman, Institute of Nephrology & Kidney Transplant, Medanta.
'In such cases, advanced therapies such as renal denervation can revolutionize treatment for resistant hypertension, allowing patients to take control of their health. Clinical evidence shows sustained BP reduction for 3+ years across varied patient groups; effectiveness in patients with chronic kidney disease, diabetes, and other co-morbidities and potential to reduce reliance on multiple medications and improve quality of life,' Dr Bansal added.
RDN shows promise in hypertension treatment
Recent clinical experiences with RDN show promising results, with reductions in blood pressure ranging between 40–45 mmHg systolic and 15–20 mmHg diastolic across diverse patient groups. Many had histories of stroke or chronic kidney disease, where hypertension was accelerating decline in kidney function. Following the procedure, their eGFR levels remained stable during 9–12 months of follow-up.
The broader benefits of blood pressure reduction are also striking. Lowering systolic BP by just 10 mmHg is linked to a 27% reduction in stroke risk, 28% in heart failure, and 17% in coronary artery disease. Patients undergoing RDN also reported a meaningful drop in medication dependence from an average of 5 drugs to just over 3, easing side effects and improving adherence.
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Baseline office BP levels in many cases averaged 186/99 mmHg, with patients experiencing nearly a 50 mmHg drop in systolic BP at discharge, and sustained improvements at one and six months.
Uncontrolled and resistant hypertension not only elevates risks of heart attack, stroke, and kidney disease but also adds to healthcare costs, hospitalisations, and productivity losses. Experts say that advanced therapies like RDN could help ease the long-term burden — enabling patients to rely on fewer medications, cut down hospital visits, and live healthier, more active lives.
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First Post
8 hours ago
- First Post
Silent killer alert: Nearly 20 cr Indians have high BP, renal denervation therapy offers new hope
India faces a hypertension crisis with only a fraction of patients controlling blood pressure. Experts point to renal denervation as a minimally invasive therapy showing sustained results in resistant cases. Read here With nearly 20 crore adults in India estimated to be living with hypertension and only about 2 crores managing to keep it under control, the condition has emerged as one of the country's most pressing public health concerns. Medical experts have warned of the rising prevalence of resistant hypertension and highlighted the role of renal denervation (RDN), an advanced therapy showing promising results in managing uncontrolled cases. A growing health concerns Data from the National Family Health Survey (NFHS) shows that hypertension prevalence ranges from 16% to over 25% in some states, with urban areas reporting a higher share of patients whose blood pressure remains uncontrolled despite treatment. In Delhi, prevalence is estimated at 28%. Experts note that about 5–10% of hypertensive patients in India may suffer from resistant hypertension, defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs. STORY CONTINUES BELOW THIS AD Resistant hypertension can progress gradually, presenting with symptoms such as frequent headaches, dizziness, breathlessness or chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs. Studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of heart disease by 20% and stroke by 27%. What is Resistant hypertension Resistant hypertension defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs is an under-recognized contributor to this challenge, affecting patients' long-term health and wellbeing. As per National Family Health Survey – 5, hypertension prevalence in Delhi is estimated to be 28%. Estimated 5-10 % of hypertensive patients in India are resistant, based on clinical practice. Resistant hypertension may progress gradually, with symptoms such as frequent headaches, dizziness, breathlessness, or occasional chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs. Average BP reduction seen in patients treated in clinic; observed improvement in cardiovascular risk profile. Clinical studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of heart disease by 20% and stroke by 27%. 25 per cent average BP reduction with Renal Denervation Dr Praveen Chandra, Chairman, Cardiology, Medanta (The Medicity) said 'While antihypertensive medicines are highly effective for many, control remains difficult for a significant number of patients. When patients understand their condition and the options available, they are better equipped to take control of their health and work with their doctors towards better outcomes.' Renal Denervation: Hypertension solution Renal Denervation is an advanced therapy that is minimally invasive, catheter-based procedure that addresses one of the underlying drivers of hypertension, overactive nerve signals between the brain and kidneys, Dr Chandra said, adding that by interrupting these signals, RDN helps lower and stabilise blood pressure over time. 'As per my experience, till date; 25% average BP reduction has been achieved in these patients; with a significant reduction seen in medication load post-procedure.' Hypertension and kidney disease closely linked 'Uncontrolled hypertension is associated with multiple risk factors, including chronic kidney disease. Hypertension is very common in patients with CKD and CKD is the most important cause of resistant hypertension. Uncontrolled hypertension can cause rapid progression of kidney disease leading to kidney failure,' said Dr Shyam Bansal, Vice Chairman, Institute of Nephrology & Kidney Transplant, Medanta. 'In such cases, advanced therapies such as renal denervation can revolutionize treatment for resistant hypertension, allowing patients to take control of their health. Clinical evidence shows sustained BP reduction for 3+ years across varied patient groups; effectiveness in patients with chronic kidney disease, diabetes, and other co-morbidities and potential to reduce reliance on multiple medications and improve quality of life,' Dr Bansal added. RDN shows promise in hypertension treatment Recent clinical experiences with RDN show promising results, with reductions in blood pressure ranging between 40–45 mmHg systolic and 15–20 mmHg diastolic across diverse patient groups. Many had histories of stroke or chronic kidney disease, where hypertension was accelerating decline in kidney function. Following the procedure, their eGFR levels remained stable during 9–12 months of follow-up. The broader benefits of blood pressure reduction are also striking. Lowering systolic BP by just 10 mmHg is linked to a 27% reduction in stroke risk, 28% in heart failure, and 17% in coronary artery disease. Patients undergoing RDN also reported a meaningful drop in medication dependence from an average of 5 drugs to just over 3, easing side effects and improving adherence. STORY CONTINUES BELOW THIS AD Baseline office BP levels in many cases averaged 186/99 mmHg, with patients experiencing nearly a 50 mmHg drop in systolic BP at discharge, and sustained improvements at one and six months. Uncontrolled and resistant hypertension not only elevates risks of heart attack, stroke, and kidney disease but also adds to healthcare costs, hospitalisations, and productivity losses. Experts say that advanced therapies like RDN could help ease the long-term burden — enabling patients to rely on fewer medications, cut down hospital visits, and live healthier, more active lives.
India Today
11 hours ago
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Resistant hypertension: The dangerous type of high BP that medicines can't fix
High blood pressure, or hypertension, has quietly become one of India's biggest health to the India Hypertension Control Initiative, nearly 20 crore adults in the country have hypertension, but only 2 crore have it under control. That means most people either don't know they have it, or their treatment isn't working well from the National Family Health Survey (NFHS) shows that hypertension affects anywhere between 16% to 25% of adults, depending on the state, with urban areas reporting a higher proportion of people struggling to keep their blood pressure in WHAT IS RESISTANT HYPERTENSION?Among those who already have high blood pressure, some suffer from what doctors call resistant hypertension. This means that despite lifestyle changes and taking three or more blood pressure medicines, their readings still stay high—often 150 mmHg or is estimated that about 5–10% of patients with hypertension in India have resistant hypertension. In Delhi alone, NFHS-5 data suggests that nearly 28% of adults have hypertension, making the challenge even more hypertension doesn't always show sudden symptoms, but it can progress slowly. People may experience frequent headaches, dizziness, breathlessness, or occasional chest discomfort. Left untreated, it places constant strain on the heart, kidneys, and other vital organs—raising the risk of heart attack, stroke, kidney failure, and heart UNCONTROLLED BLOOD PRESSURE IS SO RISKYHigh blood pressure is a major health issue, yet it remains under-recognised and undertreated both globally and in India."Only about one in ten patients have their blood pressure under control. Many don't check it regularly, or they don't take their medicines as prescribed. But controlling blood pressure is critical—it's one of the leading causes of kidney failure, heart failure and strokes," Dr. Praveen Chandra, Chairman, Cardiology, Medanta, tells fact, even a small reduction of just 2 mmHg can lower the risk of heart attack, kidney failure and stroke by 20–25% in a year.A NEW OPTION: RENAL DENERVATION THERAPYFor people with resistant hypertension, doctors in India are now turning to a new treatment called renal denervation therapy (RDN). This is a minimally invasive, one-time procedure that takes about an hour, requires only a day in hospital, and doesn't involve surgery, stitches, or general anaesthesia.'In this therapy, radiofrequency energy is delivered to the arteries supplying the kidneys. Since the kidneys play a key role in blood pressure control, this resets the nerve signals that keep the blood pressure elevated. The procedure is painless, safe, and has shown very good results," explains Dr. it is currently expensive (around Rs 5–6 lakh), RDN has shown long-lasting benefits. In India, patients have seen their blood pressure drop significantly, by about 40–45 mmHg systolic and 15–20 mmHg diastolic, with improvements sustained for KIDNEYS MATTER IN HYPERTENSIONKidneys and blood pressure are closely linked. 'Uncontrolled hypertension is associated with multiple risk factors, including chronic kidney disease (CKD). Hypertension is very common in patients with CKD, and CKD is the most important cause of resistant hypertension,' says Dr. Shyam Bansal, Vice Chairman, Institute of Nephrology & Kidney Transplant, hypertension can cause rapid progression of kidney disease leading to kidney failure. In such cases, advanced therapies such as renal denervation can revolutionize treatment, allowing patients to take control of their evidence shows sustained blood pressure reduction for over 3 years, even in patients with diabetes, CKD, and other conditions.'Lowering systolic blood pressure by just 10 mmHg can reduce the long-term risk of stroke by 27%, heart failure by 28%, and coronary artery disease by 17%. Patients who undergo RDN have also been able to reduce their dependence on medicines, from an average of five to just over three, making treatment easier and side effects fewer.- EndsMust Watch
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The right choice, baby: Family size aspirations mustn't go unmet
India's declining total fertility rate (TFR) has caused intense public debate in recent months. The suggestions have been extreme— from abandoning family planning policies to public appeals by political leaders for women to have more children. The UNFPA, in itsState of World Population 2025 report claims that the problem is neither over-population nor under-population, but instead a crisis of reproductive agency and inability to fulfil one's choice. Our essay aims to go beyond symptoms and explore the deeper malaise that has accompanied economic growth and industrialization across the world. Our core hypothesis is that the rapid decline in fertility is largely on account of a breakdown of the family structure—one of the oldest institutions known to human society. Also Read: India's falling fertility rate calls for fast-improving gender justice The UNFPA report frames reproductive agency primarily in terms of whether an individual is able to fulfil their desired fertility, highlighting both under- and over-achievement of personal fertility goals as the crisis. It is based on an online cross-country survey that asks about the desired number of children, difference between ideal and actual fertility, reasons for or against parenthood, access to reproductive health, etc. In India, the survey covered 1,048 adults aged 18-88 years in urban and rural areas. It highlights economic concerns like financial limitations (38%), housing constraints (22%), unemployment/job security (21%) and insufficient childcare (18%) as major hold-backs. Consequently, the report places much emphasis on improving reproductive agency through solutions that include housing, job security and financial enablers. Viewing the problem of fertility under-achievement through just an economic lens is myopic. For instance, in Sweden, a high-income country that is top ranked by Unicef for family-friendly policies, 17% of people expect to have fewer children than their ideal, higher than the all-country average of 11%. This suggests that even if established economic burdens ease, psychological, cultural and structural factors still affect fertility outcomes. Also Read: What it means to have a fertility rate of 2 Focusing on economic circumstances alone offers an incomplete understanding of fertility challenges, particularly in the context of India's rapidly crumbling traditional family structure. The National Family Health Survey (NFHS), a large and nationally representative health survey conducted since 1990, allows us some deeper insights into the nature of the demographic transition unfolding around us. It reveals a steady decline in both the desired and actual fertility rate over time. Rapid nuclearization of families and rampant urbanization across the country have eroded the institutional arrangement of the traditional family that encouraged and supported the bearing and rearing of children. The ethos of 'It takes a village to raise a child' has been replaced by struggling urban couples whose fertility-aspiration barriers are not strictly financial, but increasingly social and logistical. Young parents nowadays have to fully absorb all the costs of raising a child, which is one of the most labour-intensive activities. This is further compounded by the intensification of parenting, as the UNFPA report also suggests, raising costs further. By contrast, in many rural areas, child-rearing is still actively shared and supported by extended family and community members, easing the burden on the primary care-giver, typically the mother, and making it easier to achieve fertility as well as work aspirations. Also Read: China's baby subsidies are tiny but could drive domestic consumption The urban-rural difference in the gap between the desired and actual fertility of women has been widening with time. As per NFHS-4 and 5, the desired number of children has remained stable at 2.2 in rural and at 2 in urban areas. However, the gap between desired and actual fertility is much wider in urban areas (0.4) than in rural areas (0.1). Urban parents are more dependent on formal, often expensive (or missing) childcare systems and face greater challenges in achieving a work-life balance. In contrast, the higher and rising labour force participation among rural women (42%) showcases the real choices and reproductive agency that familial support offers, helping them reconcile fertility and workforce participation. Urban women continue to have significantly lower labour force participation (25%) and their actual fertility rate had fallen below the replacement level two decades ago! It is important to recall that urban women, including those working outside the household, continue to spend significant time daily on care-giving and household chores—and, as a consequence, have significantly less leisure time compared to their male counterparts. Meanwhile 'housewives' continue to see their value being discounted by society, despite contributing significantly within the household. Also Read: Equitable access will help improve reproductive health Does the gap between desired and actual fertility differ across wealth groups? The data shows that this gap widens with rising wealth levels, thereby challenging the assumption that economic limitations are the primary barriers to achieving desired fertility. In a rapidly changing society where traditional systems of familial support are disappearing, the state can and must facilitate the development of childcare, parental leave and financial assistance to support families. However, the ability of contractual market institutions or the government to function as a replacement for family support remains limited, as the experience of affluent nations shows. India faces multiple challenges that overlap: regional variations in fertility and ageing, the imperative of inclusive economic growth and the need to deliver social services to a large population. Fertility trends are not just about demographics; they reflect transformations in health, education and socio-economic realities. While improvements in access to reproductive health services and social security systems are indispensable, overlooking the social transformation of families and its impact on fertility aspirations can have long-term consequences for the well-being of individuals and society. Also Read: Women's participation in the labour force: It's too risky to let it languish With a GDP per capita of $11,159 (purchasing power parity, 2024; World Bank), India must plan to grow rich before growing old. Alongside investments in human capital, reproductive health and opportunity creation, policy foresight is needed for a careful assessment of the implications of a rising dependency ratio on state capacity, fiscal resources, care systems and the long-term sustainability of social protection measures. Most importantly, our policies must support the institution of family that is under tremendous pressure. To discount the significant care-work within families is to discount the future of our society. India's economic growth must have Indian characteristics and values. We must not repeat the mistakes made by nations that are economically ahead of us. The authors are, respectively, member and young professional, Economic Advisory Council to the Prime Minister (EAC-PM).
