Hypertension and Diabetes Rise Among India’s Poor

A patient being checked for BP at Mann PHC.

Generally thought to be diseases of wealthier classes, non-communicable diseases (NCDs) like hypertension and diabetes are on the rise among India’s underprivileged working communities in semi-urban and rural areas.

Take the case of Mohan Ahire, a middle-aged gardener in Pune. He never realized that the heaviness in his head was a symptom of hypertension. Last summer, he fell unconscious during a mid-morning market visit. Upon regaining consciousness, his wife and sons noticed paralysis on the right side of his body, and doctors diagnosed a stroke.

Bahinabai Gaekwad, a 56-year-old sweeper in Mann village, collapsed and died at work. Doctors from the Primary Health Centre (PHC) nearby found she had suffered from undiagnosed hypertension for a long time, ultimately leading to fatal cardiac arrest.

The bigger problem is that most patients from underprivileged sections are unaware of their health conditions.

Praful Mahato, a migrant laborer from Balasore, Odisha, employed at a dhaba in Mann—a fast-industrializing rural outpost of Pune—experienced heaviness and dizzy spells for some time. He attributed these symptoms to long hours at work. A medical camp visit confirmed high blood pressure and diabetes. Medication over the last four months has now controlled his blood pressure and reduced his sugar levels.

Jagdish Mondol, in his 50s, discovered he had hypertension and diabetes only when preparing for a hernia operation at a government hospital in Bhadrak, Odisha. Blurred vision and difficulty walking had preceded the diagnosis. Regular medication has since improved his condition.

Some patients may seek help proactively. Lalita Parshuram Jadhav, a 40-year-old migrant construction worker from Yavatmal, is one such example. “Over the past two years, I experienced leg pain, which became acute in the last year,” she told IPS. A medical check-up confirmed hypertension and high sugar levels.

These cases exemplify the rising burden of hypertension and diabetes in India. Ranked among the top ten NCDs responsible for untimely deaths worldwide, the two diseases are interlinked. Individuals with hypertension are also vulnerable to developing prediabetes and diabetes.

According to the World Health Organization (WHO), an estimated 1.28 billion adults aged 30–79 suffer from hypertension, two-thirds of whom live in low- and middle-income countries. Only 21 percent have their hypertension under control, and about 46 percent remain undiagnosed.

Diabetes can be Type 1 (congenital) or Type 2 (lifestyle-related). South Asians, Pacific Islanders, and Native Americans face a higher risk of developing the disorder. The International Diabetes Federation (IDF) has recorded a dramatic increase in Type 2 diabetes globally since the 1990s. In India, an estimated 77 million adults have diabetes (Type 2), and nearly 25 million are prediabetic, with more than 50 percent unaware of their status.

The prevalence of diabetes in India rose from 7.1 percent in 2009 to 8.9 percent in 2019. Around 43.9 million people remain undiagnosed and untreated, posing a major public health risk. Most deaths occur between ages 30 and 70, causing significant economic loss.

In Mann, PHC doctors report hypertension affects around 28 percent of the population and 12 percent are diabetic. Similar trends are observed in Mullaheera, rural Haryana, near Delhi.

Dr. Sona Deshmukh of the People-to-People Foundation, collaborating with the Government of India on the Viksit Bharat @2047 initiative, notes, “Diabetes is common among the older population, but hypertension is rising among youth.”

Many people view these diseases as benign, yet ignoring them can lead to strokes and death. Uncontrolled hypertension can cause chest pain, heart attack, heart failure, or sudden death. Diabetes can lead to blindness, kidney failure, heart complications, and strokes.

Drs. Mayadevi Gujar and Vaishali Patil cite lifestyle changes due to semi-urban industrialization. Traditional diets of millets and cereals are replaced by oily snacks, sugary drinks, and fast food. Tobacco and alcohol use are rising, and climate-related stress further exacerbates risks.

Dr. Sundeep Salvi highlights sleep deprivation, late-night routines, and lack of exercise as key contributors. He also emphasizes indoor and outdoor air pollution as significant risk factors.

Prof. Chittaranjan Yajnik links diabetes risk to poor intrauterine growth, often due to maternal undernutrition, affecting organ development. This “dual teratogenesis” means undernutrition early in life combined with later overnutrition can lead to prediabetes and diabetes.

India’s Ministry of Health and Family Welfare has implemented nationwide primary health initiatives, including nutrition, medical care, immunization, and wellness sessions. Yoga promotion, regular screenings, and counselling aim to encourage healthier lifestyles and early detection. These steps are expected to help curb the epidemic.