High blood pressure surge in India: NFHS-6 data reveals alarming health trend

Even as India records improvements in child nutrition, vaccination coverage, and maternal health, the latest National Family Health Survey (NFHS-6) reveals a worrying trend among adults: high blood pressure continues to affect a significant share of the population, underscoring the country's growing burden of non-communicable diseases.

According to the NFHS-6 (2023-24), 19.4 per cent of women and 22.1 per cent of men aged 15 years and above have elevated blood pressure or are on medication to control it. The figures represent millions of Indians living with a condition that is often called the 'silent killer' because it can progress without noticeable symptoms while increasing the risk of heart disease, stroke and kidney failure.

The survey comes at a time when India is undergoing a major epidemiological transition. While infectious diseases and undernutrition remain concerns in several regions, lifestyle-related illnesses such as hypertension, diabetes and obesity are becoming increasingly common across both urban and rural India.

Recently released NFHS-6 data show that men are more likely than women to have hypertension. Among men, 12.4 per cent had mildly elevated blood pressure, that is systolic 140-159 mm Hg and diastolic 90-99 mm Hg. 3.3 per cent of men had moderately or severely elevated blood pressure, that is, systolic ≥160 mm Hg and/or diastolic ≥100 mm Hg. Overall, 22.1 per cent had elevated blood pressure or were taking medication to control it.

Among women, 9.4 per cent had mildly elevated blood pressure. 4.8 per cent had moderately or severely elevated blood pressure. Overall, 19.4 per cent had elevated blood pressure or were on treatment.

While the difference between men and women is not dramatic, the consistently higher prevalence among men mirrors broader trends seen in cardiovascular disease risk factors, including tobacco use, alcohol consumption and sedentary lifestyles.

One of the more striking findings is that hypertension is no longer primarily an urban phenomenon.

Among women, 23.5 per cent in urban areas had elevated blood pressure compared with 17.8 per cent in rural areas. Among men, the gap was similarly narrow, with 26.2 per cent in urban areas and 20.4 per cent in rural areas reporting elevated blood pressure or being on medication.

The data suggests that lifestyle changes traditionally associated with cities, including reduced physical activity, changing dietary patterns, stress and increasing obesity, are now affecting rural populations as well.

Public health experts have long warned that rural India is witnessing a rapid rise in non-communicable diseases even as healthcare systems remain largely geared towards maternal and child health services.

The hypertension numbers appear alongside other indicators that point towards a growing metabolic health crisis.

NFHS-6 found that 27.3 per cent of women were overweight or obese, 17.8 per cent of women had high blood sugar levels or were on medication for diabetes, and 20.9 per cent of men had high blood sugar levels or were on treatment.

The coexistence of obesity, diabetes and hypertension is particularly concerning because these conditions often reinforce one another and substantially increase the risk of cardiovascular disease.

The latest survey paints a picture of a country facing two health realities at once.

On one hand, India has made measurable gains in child nutrition. Stunting among children under five has fallen from 35.5 per cent in NFHS-5 to 29.3 per cent in NFHS-6, while underweight prevalence has also declined.

On the other hand, adult health indicators suggest a growing burden of chronic diseases that require long-term management rather than short-term treatment.

"Hypertension is one of the biggest public health challenges facing India today because many people do not know they have it until they develop complications such as a heart attack, stroke or kidney disease," says Dr Ramesh Shah, consultant physician at Prabhadevi in Mumbai. "What the NFHS-6 data tells us is that high blood pressure is no longer an urban problem. We are seeing increasing numbers of patients from smaller towns and rural areas as well. Rising obesity, sedentary lifestyles, stress, high salt consumption and diabetes are all contributing to this trend."

Unlike infectious diseases, hypertension often requires lifelong monitoring, regular medication and behavioural changes such as reduced salt intake, increased physical activity and weight management.

With nearly one in five women and more than one in five men already living with elevated blood pressure or receiving treatment, experts say the next phase of India's health challenge may be less about combating disease outbreaks and more about preventing heart attacks, strokes and other chronic illnesses linked to modern lifestyles. Further, this data also suggests that the battle against high blood pressure is no longer confined to India's cities alone.