Indian Doctors Warn Against Adopting Europe’s Relaxed Hypertension Guidelines

Mumbai: As the European Society of Cardiology (ESC) raises the diagnostic threshold for hypertension, Indian health experts are voicing concerns. The ESC has revised the benchmark for high blood pressure from 130/80 mmHg to 140/90 mmHg. However, Indian doctors warn that such a change could delay diagnosis and reduce the chances of early lifestyle interventions often most effective in the initial stages of the disease.

In India, maintaining the 130/80 mmHg threshold is seen as essential for early detection and better disease management, especially among high-risk groups.

“In India, we typically diagnose hypertension at 130/80 mmHg, particularly in high-risk individuals such as those with diabetes, kidney disease, or heart conditions. This aligns with the American Heart Association’s guidelines and allows for early intervention to prevent long-term complications,” said Dr. B.C. Kalmath, Director of Cardiology, KIMS Hospitals, Thane.

Dr. Kalmath noted that Europe’s revised guidelines, which retain the diagnostic threshold at 140/90 mmHg while introducing a new “elevated blood pressure” category (120–139/70–89 mmHg), are based on their population's risk profile. “But this may not suit Indian patients,” he warned. “Due to genetic predisposition, high salt intake, stress, and sedentary lifestyles, Indians tend to develop cardiovascular diseases earlier and at lower blood pressure levels.”

He cautioned that adopting a higher diagnostic threshold in India could result in many early-stage or borderline hypertension cases going undiagnosed and untreated—raising the risk of severe complications such as stroke, heart attack, heart failure, kidney disease, and vision loss.

Dr. Swarup Swaraj Pal, Senior Consultant, Cardiovascular and Thoracic Surgery, Gleneagles Hospitals, Parel, added that India's standard blood pressure threshold is 140/80 mmHg for people under 50. “As we age, our arteries stiffen due to calcium buildup, making a BP of 140/90 mmHg acceptable for those above 60. Overcorrecting to 120/80 in the elderly can lead to dizziness and symptoms of low blood pressure,” he explained.

In conclusion, while the ESC’s updated guidelines may reflect European risk profiles, India requires population-specific strategies. Experts stressed that regular screening, early diagnosis, and timely intervention remain the most effective ways to combat the growing burden of hypertension-related illnesses.

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