Hypertension, commonly known as high blood pressure, is often called the “silent killer” because it typically produces no obvious symptoms until it has already damaged the heart, arteries, brain or kidneys.
It affects millions of people worldwide, quietly elevating the risk of heart attack, stroke, heart failure and chronic kidney disease. Once viewed primarily as a condition of middle age or later, hypertension is now striking younger adults earlier than ever, driven by urban lifestyles, chronic stress, poor diet and sedentary habits.
According to the World Health Organization’s Global Report on Hypertension 2025, an estimated 1.4 billion adults aged 30–79 years worldwide were living with hypertension in 2024 — representing 33% of adults in that age group. Two-thirds of these individuals live in low- and middle-income countries. Alarmingly, only about 23% (roughly 320 million people) have their blood pressure adequately controlled through medication or lifestyle measures.
In India, the burden is rising sharply among working-age adults. Data from the National Family Health Survey-5, indicate hypertension prevalence of around 24% among men and 21.3% among women aged 15–54 years, with urban rates often higher. Another ICMR study reports an overall weighted prevalence of hypertension at 35.5% among adults aged 20 and older, with urban areas showing elevated figures.
Among urban Indian men in the 25–54 age bracket, prevalence reaches approximately 35–40% based on analyses of NFHS-5 and related surveys, while in the 30–39 group, prehypertension and early hypertension are particularly concerning. Awareness remains low, only about 25% of affected men know their status and control rates hover between 12–23% nationally, despite India’s target of a 25% relative reduction in raised blood pressure by 2025. Young urban professionals in corporate roles face compounded risks from long hours, stress and irregular eating patterns.
Rahul Mehta is one such professional who got the wake-up call during what he thought was just another routine corporate health check-up. Rahul, a 35-year-old mid-level manager at a multinational logistics firm in Bengaluru considered himself “too young for heart problems”.
Living alone in a rented apartment, with his parents and younger sister in Mumbai, he led a high-pressure life of 10–12-hour workdays, frequent travel, skipped breakfasts, takeaway lunches and late carb-heavy dinners. Weekends often involved social drinking with colleagues. He had quit smoking three years earlier but exercised only sporadically. “I sign up for the gym every January,” he later admitted, “and by March I’m travelling again.” Friends on business trips noticed his heavy snoring; he woke up unrefreshed most mornings but blamed jet lag or hotel beds.
His hypertension was first detected at age 32 during a routine corporate screening where his blood pressure was at 148/96 mmHg. “I assumed it was just stress,” he recalled. “We were trying to close a major contract for weeks.”
Doctors advised lifestyle changes, but he did not start regular medication. Follow-up readings stayed elevated, and an echocardiogram later showed early left ventricular relaxation abnormality, a subtle sign that his heart was already straining.
By 35, frequent headaches and persistent fatigue brought him back for a comprehensive evaluation. Clinical findings revealed a classic pattern of emerging metabolic syndrome- overweight BMI, elevated LDL cholesterol, low HDL, borderline-high triglycerides, impaired fasting glucose, vitamin D deficiency and mildly raised uric acid. Waist circumference had increased noticeably.
When his doctor explained the interconnected risks, Rahul went quiet. “So this is how it starts?” he asked. “Heart disease in your thirties?”
Living alone added another layer- meals were rarely balanced or home-cooked; emotional support came mainly through video calls. “My mother keeps telling me to eat properly,” Rahul said with a half-smile. “I just don’t tell her about the blood pressure.” Work culture, performance metrics, constant travel and limited recovery time, kept the stress cycle going.
Rahul’s experience mirrors a growing trend that specialists are seeing more frequently. Dr Gagandeep Singh, MBBS, Founder of Redial Clinic, points out that hypertension at 35 is far more common in urban Indian men than most assume. Drawing from NFHS-5 and ICMR-INDIAB data, he notes that 35–40% of urban men aged 25–54 are already hypertensive, with prehypertension peaking at around 36% in the 30–39 group.
Dr Gagandeep who is a specialist in reversing diabetes, hypertension, obesity and PCOS without medication adds, “Over a third of seemingly healthy young men are sitting at the doorstep of clinical hypertension,” he says, “yet only about 25% are even aware of their condition.” Sedentary desk jobs, high sodium from processed and restaurant food, visceral fat and chronic stress, he explains, have shifted what was once a disease of the fifties into the mid-thirties.
The mechanisms behind Rahul’s condition are well understood. Chronic stress, long hours and irregular meals create a perfect storm. Dr Singh describes, “Persistent activation of the hypothalamic-pituitary-adrenal axis (system for managing stress) floods the body with cortisol, promoting sodium retention, arterial stiffness and visceral fat accumulation each independently raising blood pressure. A disrupted circadian rhythms from extended workdays suppress melatonin and blunt the natural nocturnal blood pressure dip needed for vascular recovery, while erratic eating causes insulin spikes, insulin resistance and sympathetic nervous system overdrive.”
Dr Singh stresses, “Hypertension is called the silent killer for good reason- most people with readings as high as 150/95 feel perfectly fine. Occasional headaches, mild breathlessness or disturbed sleep can appear but are too nonspecific to serve as reliable warnings. By the time more overt symptoms emerge- chest discomfort, visual changes or persistent headaches, target-organ damage such as thickened heart muscle, early kidney impairment or retinal changes is often already underway,”
“The only reliable indicator is measurement itself,” he emphasises. “Routine blood pressure checks, ideally at home with a validated digital monitor at least twice a week after 30, are essential. Waiting for symptoms is not screening, it’s a gamble.”
What Routine Tests Should People In Their 30s Not Skip?
For someone in their 30s, standard check-ups often fall short. Dr Singh recommends a more focused metabolic panel:
- Fasting lipid profile (paying close attention to triglyceride-to-HDL ratio as a key insulin resistance marker)
- Fasting glucose with fasting insulin and HOMA-IR to catch resistance years before diabetes
- HbA1c
- Kidney function tests
- Liver ultrasound for fatty liver
- Thyroid screening
- Baseline ECG
For those with family history, he suggests adding apolipoprotein B and high-sensitivity CRP. A common mistake, he observes, is trusting “normal” fasting glucose while fasting insulin is already elevated, metabolic dysfunction can simmer for years before glucose rises.
Rahul’s emerging metabolic syndrome amplified his risk significantly. Dr Singh explains that the clustering of abdominal obesity, high blood pressure, elevated triglycerides, low HDL and impaired fasting glucose multiplies cardiovascular danger rather than merely adding to it.
“The cardiovascular association with metabolic syndrome is actually strongest in younger people and diminishes with age,” Dr Singh notes. “A 35-year-old with this profile faces proportionally greater relative risk than a 60-year-old with the same factors. The window for reversal is open, but it’s narrowing.”
Rahul now shares his experience more openly with colleagues and family. During his last visit he reflected, “I thought heart disease was something that happens at fifty. Now I know prevention starts at thirty-five.”
In India, non-communicable diseases already account for over 60% of deaths, stories like Rahul’s prove that recognising the warning signs early turns potential crisis into opportunity. Heart health, it turns out, is not a distant concern, it is a present-day priority that begins the moment subtle symptoms appear.
