New Delhi: Winters can be uncomfortable for many people, but they can prove life-threatening for those with hypertension if they don’t take precautions. As the temperatures drop, the blood pressure rises to adapt to the cold, which can be dangerous for individuals with hypertension. Doctors advise hypertensives to be meticulous in monitoring their blood pressure, adhering to medications, engaging in regular physical activity and eating heart-healthy foods.
Dr Rommel Tickoo, director of internal medicine, Max Super Speciality Hospital, Saket, explained that blood pressure rises in winter due to blood vessel contraction (vasoconstriction) to preserve body warmth. The constricted veins cause blood flow resistance, resulting in elevated blood pressure levels. He indicated that medication adjustments were frequently necessary during this season. He has noticed numerous patients, even those with BP under control, showing elevated readings with systolic (top) readings of 170-180 up to 200 sometimes.
“Neglecting hypertension, particularly during winter months, can pose serious risks to life,” warned Dr Amar Singhal, director, interventional, clinical and critical cardiology and electrophysiology, Sri Balaji Action Medical Institute. He said that when high pressure remained unmanaged, the chances of critical complications, including heart attacks, strokes, kidney failure, and heart failure also were higher. Prolonged periods of untreated hypertension can result in irreversible damage to essential organs and considerably shorten one’s lifespan.
Regarding BP medicines, Dr Ravi Prakash, senior consultant, cardiology, PSRI Hospital, said that blood pressure treatment encompassed four-five medication categories, selected according to additional health conditions such as diabetes, kidney disease or heart ailments. For patients with isolated hypertension, treatment plans are personalised based on concurrent conditions, age and severity.
Dr Varun Bansal of Indraprastha Apollo Hospitals discussed newer antihypertensive medications, including angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose co-transporter-2 inhibitors (SGLT2) and direct renin inhibitors. He noted that ARNIs such as sacubitril/valsartan provided dual benefits for BP control and heart protection. SGLT2 demonstrated effectiveness in blood pressure management and cardiovascular risks reduction, while direct renin inhibitors like aliskiren targeted blood pressure regulation enzymes. These drugs add to the traditional options like ACE inhibitors, calcium channel blockers and diuretics.
Bansal also compared cilnidipine and amlodipine besylate, both calcium channel blockers. Cilnidipine affects both L-type and N-type calcium channels, whilst amlodipine targets only L-type channels. “For patients who experience swelling (edema) as a side effect of amlodipine, cilnidipine presents a viable alternative with a lower likelihood of such complications,” said Bansal. “The choice of medication is determined by individual patient circumstances, including the presence of conditions such as diabetes or kidney disease.”
Healthcare experts advise patients on long-term hypertension treatment to undergo regular medication reviews every 3-6 months or sooner. Consistent monitoring is crucial as medication effectiveness may vary over time. Dr Sanjay Mittal, vice-chairman, clinical and preventive cardiology, Medanta Gurgaon, endorsed automatic BP monitoring devices for this. He, however, pointed out that correct positioning with supported arms during measuring pressure, multiple readings for accuracy and regular device calibration made readings more accurate and revealed that arm readings might differ by up to 10mm, so suggested consistent use of the arm showing the higher readings.
Dr Udgeath Dhir, head, CTVS and heart transplant, Fortis Guraon, explained that contrary to common belief, blood pressure does not need to be exactly 120/80. The acceptable systolic range lies between 90 to 120, while the diastolic range spans from 60 to 90. For patients aged over 70 years, a 10-point elevation in these values is allowed. Nevertheless, Dhir emphasised that the systolic pressure should remain under 140 and the diastolic, below 90. He recommended taking measurements twice daily. One should record the first reading right after waking up, before having morning tea. The second measurement should be taken in the evening following at least a 30-minute rest after returning from work.
