Hypertension is increasingly being diagnosed in young adults across India, but doctors are raising alarm over a worrying shift in its underlying causes. New research reveals that more than one in five Indians aged 18 to 40 with hypertension are affected by secondary hypertension—a form of high blood pressure caused by identifiable medical conditions and associated with greater health risks.
Globally, nearly 90 percent of people with hypertension are believed to have primary hypertension, which develops gradually and is often linked to genetics and lifestyle factors. However, the Indian study highlights a stark contrast, suggesting that secondary hypertension is far more prevalent among younger patients in the country than previously assumed.
Hypertension remains one of the leading contributors to cardiovascular disease worldwide, accounting for nearly 17.9 million deaths annually, according to the World Health Organization (WHO). In India alone, an estimated 30 to 35.5 percent of the population—around 31.4 crore people—live with high blood pressure. Alarmingly, a large proportion of patients fail to keep their condition under control despite being on medication.
Doctors explain that primary hypertension usually develops slowly and remains asymptomatic for years, often causing damage to the heart, brain, kidneys, and eyes before it is detected. Secondary hypertension, on the other hand, tends to appear suddenly, affect younger individuals, and remain resistant to standard blood pressure treatments.
“Secondary hypertension has a clear underlying cause, such as kidney disease, hormonal disorders, or certain medications,” said Dr. Ashish Jai Kishan, cardiologist at Fortis Hospital, Delhi. “Because it presents aggressively and often does not respond to routine therapy, it is frequently missed.”
Experts emphasise that recognising the distinction between primary and secondary hypertension is crucial. Treating all high blood pressure as the same condition can delay appropriate diagnosis and increase the risk of serious complications.
“Hypertension is not a one-size-fits-all disease,” said Dr. Subho Sarkar of Sir H. N. Reliance Foundation Hospital. “Precision treatment and targeted investigation are essential, especially in younger patients.”
Clinicians warn that greater awareness, early screening, and diagnostic vigilance are urgently needed to prevent long-term cardiovascular damage in India’s young population.
