World Hypertension Day: Why some people get hypertension despite living a healthy lifestyle

New Delhi:

Managing hypertension is often described in relatively simple terms: eat healthy, exercise regularly, reduce stress and maintain a balanced lifestyle. It is advice that many people genuinely follow. Yet, despite doing everything “right”, some individuals still develop high blood pressure.

According to Dr Ramesh Menon, Director of Personal Genomics and Genomic Medicine at MedGenome, the answer often goes beyond lifestyle alone. Genetics may quietly play a much larger role than many people realise.

Blood pressure regulation is more complex than it appears

Dr Menon explains that blood pressure is controlled through a highly coordinated biological system involving the kidneys, blood vessels and hormones. One of the body’s most important mechanisms for regulating blood pressure is the Renin-Angiotensin-Aldosterone System (RAAS), which helps manage:

While genetics may increase risk, experts stress that healthy habits still remain extremely important.

Balanced nutrition, regular physical activity, proper sleep, stress management and timely medical check-ups continue to play a major role in reducing hypertension-related complications.

People with a strong family history of high blood pressure are encouraged to discuss preventive screening and early monitoring options with their doctors.

• Fluid balance
• Sodium retention
• Blood vessel constriction

However, this system does not function identically in every individual. Small genetic differences can affect how the body reacts to salt, stress, and changes in circulation.

“For some individuals, even a fairly normal salt intake can raise blood pressure significantly because their bodies may be more salt-sensitive genetically,” Dr Menon explains.

Why hypertension can develop silently

One of the biggest challenges with hypertension is that it often develops gradually without obvious warning signs. For years, blood pressure may remain only slightly elevated before slowly progressing into a serious long-term condition. According to Dr Menon, this silent progression is one reason early risk identification is becoming increasingly important in preventive healthcare.

“People often feel confused when they develop hypertension despite maintaining healthy habits. Many start questioning whether they missed something. In reality, genetics may already be increasing their baseline risk,” he says.

Family history may matter more than people think

The expert says family history has long been recognised as one of the strongest risk factors for hypertension. However, hypertension is rarely caused by a single faulty gene. Instead, it usually develops through a combination of multiple small genetic variations interacting with lifestyle, stress and environmental factors over time. “Genes do not work in isolation. They constantly interact with diet, stress levels, sleep patterns and everyday lifestyle habits,” Dr Menon explains.

This is why two individuals with similar lifestyles may still experience very different health outcomes.

Why younger Indians are increasingly being diagnosed

High blood pressure is no longer viewed as a condition affecting only older adults. Increasingly, people in their late 20s and 30s are also being diagnosed with hypertension. According to Dr Menon, South Asians are recognised to have a higher susceptibility to cardiometabolic disorders, including hypertension.

“In some individuals, the body may react more strongly even to moderate lifestyle risk factors, which can lead to earlier onset of disease,” he says. This means that even individuals who believe they are living relatively healthy lifestyles may unknowingly carry increased inherited risk.

The approach towards hypertension is slowly shifting from reacting to the disease after diagnosis towards identifying risk much earlier. Dr Menon says preventive genomics is beginning to play an important role in this transition. By analysing genetic patterns, doctors may be able to identify elevated risk even before symptoms appear.

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