You Don't Have to be a Doctor to Save Lives

Audio and YouTube versions available at the end of this email.

In Dec 2024, I wrote about how as individuals we can make a difference by getting those around us tested for diabetes for less than Rs. 150 per person. For under Rs. 1500, we could screen at least 10 people around us (help, chauffeurs, cooks, etc.) and make a difference.

The same holds true for high blood pressure. 

For context, in Nov 2025, I drilled down the GBD 2023 data to say that high blood pressure is the single largest killer in India in the age group of 50-69 years, responsible for 19% of all deaths in that age group (1 in 5) [1]. 

The ICMR-INDIAB study [2] found a prevalence of high blood pressure in 35.5% of Indians above the age of 20…1 in 3 adult Indians using the older cut-off of 140/90. A LASI analysis [3] found a 45.9% prevalence in those over the age of 45 (almost every other Indian over 45) and of these only 55.7% had been diagnosed. This means that if you have 100 people over the age of 45 years in a room, 46 will have high blood pressure and of these 25 would have been diagnosed, while 21 (one in 5) would be undiagnosed. Worse, of the 46 with high blood pressure, only 18 would be on treatment and only 15 would be controlled. 

It gets worse. The new 2025 guidelines [4] now emphasize a cut-off for a diagnosis of high blood pressure of 130/80, whether at home or in office. A 130/80 cut-off would double those now considered to have high blood pressure, from 28.1% to 59.9% of adult Indians, according to Ambuj Roy and Dorairaj Prabhakaran [5]…in that room of 100 people, many more now will have high blood pressure than just 46 people.

In short, taking care of high blood pressure (detection and treatment) is perhaps the single best act of early detection that we can do and one of the few things in medicine that can be fixed. Every 10 mm Hg reduction of the systolic blood pressure reduces major cardiovascular events by 20%, stroke by 27% and death from any cause by 13% [6].

That is where atmasvasth comes in. Measuring your own blood pressure at home regularly, which I first wrote about in Aug 2021 is one of the 15 points to live long, healthy. What changes now is the number. I had mentioned that if the blood pressure is above 135/85, you must see a doctor for treatment options. Now, that number is 130/80. You must measure your own blood pressure at least once a quarter, after 5 minutes of sitting quietly, twice a day, two readings at a time, for 3 days continuously to ensure that your blood pressure is under control, whether on treatment or not. 

And, like with diabetes, we can make a difference by using our home blood pressure unit to test those around us…children, spouses, parents, other relatives, help, chauffeurs, cooks and all who come into the ambit of our daily lives. While this is logical and will help detect and then hopefully treat people who have undiagnosed high blood pressure, there is a good quality Indian study [7] that shows how that actually worked in a village. 

Rohit Bhatia and his colleagues conducted a study in a village in Haryana and gave 212 households a blood pressure machine and told the other 212 households to visit the local health centre. Three months later, they had a pick-up rate of high blood pressure of 43% in those with the home machine and 12% in those without, though 100 of those 212 never went to the health centre. 

More importantly, 551 adult family members in the home machine households had said they did not have high blood pressure and 149 of them (27%) turned out to have a reading equal to or more than 135/85. The average age was 39 and these were the children, young relatives, etc.

The problem in our country as seen in the LASI study is that even after a diagnosis, a good number don’t get treated or don’t know what to do with that diagnosis of high blood pressure.

You can make a difference. If you test with your home machine say at least 10 people around you who have either never been tested or were tested at some point in time a few years ago, you will find anywhere between 3-5 people with a high reading and if you do then you should measure for 2 more days. If the average of 3 days remains high, you should then ask them to see a doctor, get a prescription for treatment and then help them buy good quality generics from chemists and pharmacies you trust or from Jan Aushadhi centres and keep checking with them if they are taking their pills regularly.

All of us talk a lot about wanting to do some good in life…but most of us land up doing nothing. Well here is something you can do. Get those around you tested for anemia (hemoglobin), diabetes (fasting blood sugar) and lipid levels and measure their blood pressure at home and then sponsor their treatment if detected to be abnormal. Even if someone has every one of these diseases, the testing will be Rs. 150-300 one time and the cost of treatment will be Rs. 100-200 per month. Given that one fricking coffee at Starbucks costs more, the difference you can make would be enormous. 

You don’t have to be a doctor to save lives.

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Footnotes

1. Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Global Burden of Disease Study 2023. Seattle, WA: IHME, University of Washington, 2025. Available from https://vizhub.healthdata.org/gbd-compare/india (accessed 30 Nov 2025). India, both sexes, ages 50–69 years.
2. Anjana RM, Unnikrishnan R, Deepa M, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol 2023;11:474-489.
3. Lee J, Wilkens J, Meijer E, Sekher TV, Bloom DE, Hu P. Hypertension awareness, treatment, and control and their association with healthcare access in the middle-aged and older Indian population: a nationwide cohort study. PLoS Med 2022;19:e1003855.
4. Jones DW, Whelton PK, Allen N, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Circulation 2025;152:e114-e218.
5. Roy A, Prabhakaran D. India's Hypertension Challenge: Young, Diverse, and Undermanaged. J Am Coll Cardiol 2025;86:1523-1525.
6. Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016;387:957-967.
7. Bhatia R, Haldar P, Longkumer I, et al. Effectiveness of home-based self-monitoring of blood pressure for hypertension detection in India (EASE-BP): an open-label, randomised controlled trial. Lancet Prim Care 2026. doi:10.1016/j.lanprc.2026.100174

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