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Understanding Digestive Disorders: Expert Insights from the Best Multi-Speciality Hospitals in Ranchi

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Discover digestive disorder symptoms & treatments from experts at the best multi-speciality hospitals in Ranchi. Samford Hospital’s complete health guide. Digestive health problems affect millions of people worldwide, yet many individuals ignore the warning signs until their condition becomes severe. Whether you’re experiencing occasional discomfort or persistent symptoms, understanding what your body is trying to tell you is crucial for maintaining optimal health.

At Samford Hospital, recognized among the best multi-speciality hospitals in Ranchi, our gastroenterology experts encounter patients daily who wish they had sought help sooner. This comprehensive guide will help you recognize common digestive disorder symptoms, understand their potential causes, and know when to seek professional medical attention.

Why Digestive Health Matters More Than You Think

Your digestive system does far more than process food. It absorbs essential nutrients, supports your immune system, and even influences your mental health through the gut-brain connection. When something goes wrong with your digestive tract, the effects can ripple throughout your entire body, impacting your quality of life, energy levels, and overall wellbeing.

The challenge with digestive disorders is that many share similar symptoms. Bloating, abdominal pain, gas, and irregular bowel movements can indicate anything from a simple food intolerance to a more serious condition requiring medical intervention. That’s why the specialists at the best multi-speciality hospitals in Ranchi emphasize the importance of not dismissing persistent symptoms. Discover digestive disorder symptoms & treatments from experts at the best multi-speciality hospitals in Ranchi. Samford Hospital’s complete health guide.

Common Digestive Symptoms You Shouldn’t Ignore

1. Abdominal Pain and Cramping

Stomach pain varies widely in intensity, location, and duration, and each variation can provide important clues about what’s happening inside your body.

Localized pain concentrated in one specific area often indicates targeted issues such as:

  • Peptic ulcers causing pain in the upper abdomen
  • Gallstones creating discomfort in the upper right quadrant
  • Appendicitis presenting as sharp pain in the lower right abdomen

Generalized pain that moves around or comes in waves might suggest:

  • Irritable bowel syndrome (IBS)
  • Food intolerances or sensitivities
  • Inflammatory conditions affecting the digestive tract

The gastroenterology department at Samford Hospital, one of the best multi-speciality hospitals in Ranchi, recommends seeking immediate medical attention if you experience sudden, severe abdominal pain, especially if accompanied by fever, vomiting, or an inability to pass stool.

2. Persistent Bloating and Excessive Gas

While occasional bloating after a large meal is normal, chronic bloating that interferes with your daily activities deserves medical evaluation.

Frequent bloating may indicate:

  • Irritable Bowel Syndrome (IBS): A common disorder affecting the large intestine
  • Small Intestinal Bacterial Overgrowth (SIBO): An excessive amount of bacteria in the small intestine
  • Celiac Disease: An autoimmune reaction to gluten causing intestinal damage
  • Lactose Intolerance: Difficulty digesting dairy products
  • Fructose Malabsorption: Problems processing certain sugars

Chronic bloating typically results from the fermentation of undigested food in your gut, signaling problems with either digestion or nutrient absorption. The experienced specialists at the best multi-speciality hospitals in Ranchi can perform diagnostic tests to identify the root cause and develop an effective treatment plan.

3. Heartburn and Acid Reflux

That burning sensation in your chest after eating isn’t something to brush off as normal, especially if it occurs frequently.

Gastroesophageal Reflux Disease (GERD) develops when stomach acid regularly flows back into your esophagus. Symptoms include:

  • Burning sensation in the chest, particularly after meals or when lying down
  • Sour or bitter taste in the mouth
  • Difficulty swallowing (dysphagia)
  • Chronic cough or sore throat
  • Feeling like there’s a lump in your throat

Left untreated, GERD can damage your esophageal lining, increase your risk of esophageal cancer, and significantly impact your quality of life. The gastroenterology team at Samford Hospital uses advanced diagnostic tools to assess GERD severity and recommend appropriate treatment options.

4. Nausea and Vomiting

While nausea often accompanies temporary illnesses like stomach flu or food poisoning, persistent or recurrent nausea warrants medical investigation.

Ongoing nausea might indicate:

  • Gastroparesis: Delayed stomach emptying that prevents proper digestion
  • Gallbladder Disease: Inflammation or gallstones affecting digestive function
  • Peptic Ulcers: Open sores in the stomach or small intestine lining
  • Inflammatory Bowel Disease (IBD): Chronic inflammation of the digestive tract
  • Pancreatitis: Inflammation of the pancreas

If you experience nausea regularly after eating, your stomach may not be processing food efficiently, potentially leading to nutritional deficiencies and weight loss over time.

5. Changes in Bowel Habits: Diarrhea and Constipation

Bowel movement patterns vary from person to person, but significant changes from your normal routine should raise concerns.

Chronic Diarrhea (loose, watery stools occurring frequently) may result from:

  • Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • Celiac disease
  • Chronic infections
  • Irritable bowel syndrome with diarrhea predominance (IBS-D)
  • Malabsorption disorders

Persistent Constipation (difficulty passing stools or infrequent bowel movements) can be caused by:

  • Slow intestinal transit
  • Low fiber intake and dehydration
  • Hypothyroidism
  • Diverticular disease
  • Certain medications

The gastroenterology specialists at the best multi-speciality hospitals in Ranchi emphasize that if these issues persist beyond a few days or occur with regularity, they require professional evaluation to prevent complications and identify underlying conditions.

6. Blood in Stool

This symptom always requires immediate medical attention, as it can indicate various conditions ranging from minor to serious.

Bright red blood typically originates from the lower digestive tract and might indicate:

  • Hemorrhoids (swollen veins in the rectum or anus)
  • Anal fissures (small tears in the anal lining)
  • Lower intestinal inflammation

Dark, tarry stools suggest bleeding higher in the digestive tract, possibly from:

  • Stomach ulcers
  • Gastritis
  • Esophageal varices

Blood in stool can also signal serious conditions like colorectal cancer or inflammatory bowel disease, making prompt medical evaluation essential.

Common Digestive Disorders Explained

Understanding specific conditions can help you recognize patterns in your symptoms:

Irritable Bowel Syndrome (IBS): Characterized by alternating diarrhea and constipation, abdominal cramping, bloating, and symptoms that often improve after bowel movements. Stress and certain foods frequently trigger symptoms.

Gastroesophageal Reflux Disease (GERD): Presents with frequent heartburn, regurgitation, chest discomfort after meals, and sometimes respiratory symptoms like chronic cough.

Celiac Disease: An autoimmune disorder triggered by gluten consumption, causing diarrhea, bloating, fatigue, weight loss, and nutrient malabsorption.

Inflammatory Bowel Disease (IBD): Includes Crohn’s disease and ulcerative colitis, both causing severe inflammation with symptoms like bloody diarrhea, abdominal pain, fatigue, and unintended weight loss.

Gallbladder Disease: Typically causes pain in the upper right abdomen, especially after consuming fatty meals, often accompanied by nausea and vomiting.

When to Visit the Best Multi-Speciality Hospitals in Ranchi

Timing is crucial when dealing with digestive health issues. Seek medical attention if you experience:

  • Symptoms persisting for more than two weeks
  • Unintentional weight loss
  • Blood in your stool or vomit
  • Daily bloating or abdominal discomfort
  • Persistent fatigue without clear explanation
  • Difficulty swallowing
  • Severe or worsening pain
  • Fever accompanying digestive symptoms

Early diagnosis and treatment prevent complications, reduce the risk of long-term damage, and improve your overall prognosis.

Why Choose Samford Hospital for Digestive Health Care

As one of the best multi-speciality hospitals in Ranchi, Samford Hospital offers comprehensive gastroenterology services with:

  • Experienced gastroenterologists and support staff
  • Advanced diagnostic equipment for accurate assessments
  • Modern endoscopy and colonoscopy facilities
  • Personalized treatment plans tailored to your specific condition
  • Holistic care addressing both symptoms and underlying causes
  • Patient education and ongoing support

Our multidisciplinary approach ensures you receive coordinated care from specialists across various departments when needed, providing comprehensive treatment for complex digestive disorders.

Taking Control of Your Digestive Health

Your digestive system works tirelessly to keep you healthy, but it needs your attention and care. Recognizing warning signs early, making informed decisions about when to seek help, and choosing quality medical care from the best multi-speciality hospitals in Ranchi can make all the difference in your health outcomes.

Don’t ignore what your gut is telling you. Persistent digestive symptoms rarely resolve on their own and often indicate underlying issues that benefit from professional medical intervention. The sooner you understand what’s happening in your body, the faster you can find relief and prevent potential complications.

If you’re experiencing any of the symptoms discussed in this article, contact Samford Hospital today to schedule a consultation with our gastroenterology specialists. Your digestive health is too important to leave to chance—take the first step toward better health now.

About Samford Hospital

Discover digestive disorder symptoms & treatments from experts at the best multi-speciality hospitals in Ranchi. Samford Hospital’s complete health guide. Samford Hospital stands among the best multi-speciality hospitals in Ranchi, offering comprehensive healthcare services across multiple specialties. Our gastroenterology department combines expert medical professionals, cutting-edge technology, and patient-centered care to deliver exceptional outcomes for digestive health conditions. Schedule your appointment today and experience the difference that quality healthcare makes.

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Blood Pressure Management: Expert Insights from the Best Hospitals in Ranchi

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Learn about high & low blood pressure symptoms, causes & prevention from experts at the best hospitals in Ranchi. Samford Hospital’s complete guide. Blood pressure management is one of the most critical aspects of maintaining good health, yet many people don’t fully understand how it affects their body until serious complications arise. Whether you’re dealing with high blood pressure (hypertension) or low blood pressure (hypotension), understanding the warning signs and prevention strategies can literally save your life. The medical experts at Samford Hospital, recognized among the best hospitals in Ranchi, have compiled this comprehensive guide to help you take control of your cardiovascular health.

Understanding Blood Pressure: The Basics

Blood pressure measures the force your blood exerts against artery walls as your heart pumps throughout your body. This measurement consists of two important numbers that tell your doctor about your heart’s health. The systolic pressure (the top number) indicates the pressure when your heart beats, while the diastolic pressure (the bottom number) shows the pressure between heartbeats when your heart rests.

According to cardiologists at Samford Hospital, one of the best hospitals in Ranchi, a normal blood pressure reading typically measures around 120/80 mm Hg. Any significant deviation from this range—whether higher or lower—requires attention and potentially medical intervention.

High Blood Pressure: The Silent Health Threat

Hypertension has earned its nickname as the “silent killer” because it often progresses without obvious symptoms. This makes regular monitoring absolutely essential, especially if you have risk factors. Many patients at the best hospitals in Ranchi discover they have high blood pressure only during routine checkups, which is why preventive care is so important.

Warning Signs of Hypertension

While high blood pressure frequently goes unnoticed, some people do experience telltale symptoms. Medical professionals at Samford Hospital, counted among the best hospitals in Ranchi, advise watching for these warning signs:

Persistent headaches that don’t respond well to over-the-counter medication can indicate elevated blood pressure. Unexplained nosebleeds, particularly in adults, may signal hypertension. You might also experience unusual fatigue or mental confusion that affects your daily activities. More serious symptoms include chest pain, irregular heartbeat patterns, and vision problems that seem to appear suddenly or worsen over time.

When hypertension remains untreated, the consequences can be severe and life-threatening. Heart attacks, strokes, kidney damage, and permanent vision loss are all potential complications that develop when high blood pressure damages your organs over months and years.

What Causes High Blood Pressure?

Understanding the root causes helps you make better prevention choices. Experts at the best hospitals in Ranchi identify several key factors that contribute to hypertension:

Dietary habits play a massive role, particularly consuming too much sodium through processed foods, restaurant meals, and excessive salt at the table. Obesity significantly increases your risk because extra body weight forces your heart to work harder to pump blood throughout a larger body mass. A sedentary lifestyle weakens your cardiovascular system over time, making you more vulnerable to blood pressure problems.

Lifestyle choices like excessive alcohol consumption and tobacco use damage your blood vessels and elevate pressure levels. Chronic stress triggers hormonal responses that keep your blood pressure elevated even during rest. Your genetics and family history also matter—if your parents or siblings have hypertension, you face higher risk. Certain medications and underlying medical conditions can also contribute to high blood pressure.

Low Blood Pressure: When Your Pressure Drops Too Low

While most health discussions focus on high blood pressure, hypotension deserves equal attention because it can be equally dangerous. Doctors at Samford Hospital, one of the best hospitals in Ranchi, explain that low blood pressure often produces more immediately noticeable symptoms than hypertension, particularly when pressure drops suddenly.

Recognizing Hypotension Symptoms

Dizziness or lightheadedness, especially when standing up quickly, is one of the most common signs of low blood pressure. Some people experience fainting episodes that can lead to dangerous falls and injuries. Blurred vision that comes and goes may indicate your brain isn’t receiving adequate blood flow. Nausea without an obvious cause, cold and clammy skin, persistent fatigue, and difficulty concentrating are all warning signs that your blood pressure may have dropped too low.

Severe hypotension becomes a medical emergency because it deprives your brain and vital organs of oxygen. If you experience extreme symptoms, seek immediate care at the best hospitals in Ranchi like Samford Hospital.

Causes of Low Blood Pressure

Multiple factors can trigger hypotension. Dehydration reduces blood volume, causing pressure to drop. Blood loss from trauma or internal bleeding dramatically lowers blood pressure. Certain medications, particularly diuretics and beta blockers, can reduce pressure as a side effect. Heart problems including slow heartbeat and heart failure affect your body’s ability to maintain healthy pressure. Endocrine disorders like adrenal insufficiency disrupt hormone balance. Severe infections causing septic shock can crash blood pressure to dangerous levels. Nutritional deficiencies, especially lacking vitamin B12 or folate, may also contribute to hypotension.

Prevention Strategies for High Blood Pressure

The cardiology experts at the best hospitals in Ranchi recommend these evidence-based prevention strategies:

Reduce Your Sodium Intake: Aim for less than 2,300 mg daily (about one teaspoon of salt), or ideally closer to 1,500 mg. Read food labels carefully because sodium hides in many processed and packaged foods.

Exercise Regularly: Commit to at least 30 minutes of moderate physical activity most days. Walking, cycling, swimming, dancing—any movement counts toward your goal and strengthens your cardiovascular system.

Manage Stress Effectively: Find healthy stress outlets like deep breathing exercises, meditation, yoga, or enjoyable hobbies. Taking regular breaks during your workday prevents chronic stress from elevating your blood pressure.

Maintain Healthy Weight: Extra pounds strain your heart and blood vessels. Even losing 5-10 pounds can produce measurable improvements in your blood pressure readings.

Limit Alcohol and Eliminate Tobacco: Moderate your alcohol consumption and quit smoking entirely. Both substances damage your cardiovascular system in ways that compound blood pressure problems.

Monitor Regularly: Use a home blood pressure monitor to track your readings. Early detection gives you more options for managing your levels through lifestyle changes before medication becomes necessary.

Prevention Strategies for Low Blood Pressure

Specialists at the best hospitals in Ranchi suggest these approaches for managing hypotension:

Stay well-hydrated by drinking plenty of water throughout the day. Avoid standing up too quickly—rise slowly from sitting or lying positions to prevent dizziness. Eat smaller, more frequent meals instead of large meals that can cause post-meal blood pressure drops. If your doctor advises it, slightly increase your salt intake (this is contrary to high blood pressure advice). Wear compression stockings if you stand frequently, as they improve blood flow and prevent pooling in your legs. Avoid alcohol since it can lower blood pressure further.

When Professional Help Is Essential

Don’t ignore persistent abnormal readings. If you experience concerning symptoms like fainting, chest pain, severe headaches, or blurred vision—or if your blood pressure consistently falls outside the normal range—consult the specialists at Samford Hospital, recognized as one of the best hospitals in Ranchi. Professional medical evaluation ensures you receive appropriate treatment before complications develop.

Managing blood pressure is about protecting your long-term health and quality of life. Your heart works tirelessly every moment of every day—give it the support it needs by keeping your blood pressure within healthy ranges through awareness, lifestyle modifications, and regular medical monitoring.

Best Orthopaedic hospital in Ranchi

Know All About Hip Replacement Surgery From The Experts Of Best Orthopaedic hospital in Ranchi

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Hip replacement surgery is a widely performed orthopaedic procedure that helps people suffering from severe hip pain regain mobility and enjoy a better quality of life. At Samford Hospital, a leading orthopaedic hospital in Ranchi, specialists provide advanced treatment options for patients dealing with arthritis, injury, and degenerative joint conditions. If you or a loved one is considering this surgery, this beginner-friendly guide will help you understand everything you need to know.

What Is Hip Replacement Surgery?

Hip replacement surgery, also known as hip arthroplasty, is a procedure in which a damaged or worn-out hip joint is replaced with an artificial implant. Doctors at a reputed orthopaedic hospital in Ranchi generally recommend this surgery for patients experiencing chronic hip pain and restricted movement that does not improve with medication, physiotherapy, or lifestyle changes.

Why Is Hip Replacement Surgery Needed?

There are several medical conditions that may damage the hip joint and require treatment at an experienced orthopaedic hospital in Ranchi:

  • Osteoarthritis: The most common cause, where cartilage gradually wears away, leading to pain and stiffness.
  • Rheumatoid Arthritis: An autoimmune disease that causes joint inflammation and damage.
  • Hip Fractures: Serious injuries that may not heal properly, especially in older adults.
  • Avascular Necrosis: Reduced blood supply to the hip bone, causing bone tissue death.
  • Congenital Hip Disorders: Structural abnormalities present from birth that worsen over time.

Early consultation at a trusted orthopaedic hospital in Ranchi can help prevent further complications.

Types of Hip Replacement Surgery

Specialists at a modern orthopaedic hospital in Ranchi may recommend one of the following procedures based on the patient’s condition:

1. Total Hip Replacement (THR)

The most common type, where both the ball (femoral head) and socket (acetabulum) are replaced with artificial components.

2. Partial Hip Replacement (Hemiarthroplasty)

Only the femoral head is replaced, often recommended for certain hip fractures.

3. Hip Resurfacing

A bone-preserving option where the femoral head is capped with a smooth metal covering instead of being fully replaced.

How Is the Surgery Performed?

At an advanced orthopaedic hospital in Ranchi, hip replacement surgery is usually performed under general or spinal anesthesia. The procedure includes:

  • Making an incision to access the damaged joint
  • Removing damaged bone and cartilage
  • Inserting artificial components made of metal, ceramic, or high-grade plastic
  • Securing the implant and closing the incision

After surgery, the patient is closely monitored before beginning rehabilitation.

Recovery and Rehabilitation

Recovery at a specialized orthopaedic hospital in Ranchi involves a structured rehabilitation plan:

  • Hospital Stay: Typically a few days depending on recovery speed
  • Physical Therapy: Starts soon after surgery to restore strength and flexibility
  • Pain Management: Prescribed medications help control discomfort
  • Activity Guidelines: Patients avoid high-impact activities and follow movement precautions

Most patients experience significant improvement within 3 to 6 months.

Benefits of Hip Replacement Surgery

Under the care of experts at a leading orthopaedic hospital in Ranchi, patients can expect:

  • Significant pain relief
  • Improved mobility
  • Better range of motion
  • Enhanced quality of life
  • Ability to return to daily activities comfortably

Risks and Possible Complications

Like any major surgery, hip replacement has certain risks, though they are uncommon when performed at a reputable orthopaedic hospital in Ranchi:

  • Infection
  • Blood clots
  • Implant dislocation
  • Gradual wear of the artificial joint
  • Rare nerve damage

Proper follow-up care greatly reduces these risks.

Who Is a Good Candidate?

You may be a suitable candidate for treatment at an experienced orthopaedic hospital in Ranchi if you:

  • Have persistent hip pain affecting daily life
  • Experience stiffness and difficulty walking
  • Do not respond to medications or physiotherapy
  • Show significant joint damage in imaging tests

Final Thoughts

Hip replacement surgery is a safe and highly effective solution for individuals struggling with severe hip pain. With modern surgical techniques and advanced implants available at a trusted orthopaedic hospital in Ranchi like Samford Hospital, patients can look forward to long-term relief and restored mobility.

If you are considering hip replacement, consult an orthopedic specialist today and take the first step toward a healthier, more active life.

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7 Myths Busted About Hypertension By The Best Cardiology Hospital In Ranchi

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Hypertension, or high blood pressure, is a widespread health issue in India. However, there are many myths surrounding this condition that lead to confusion and improper management. In this blog, expert cardiologists from the best hospital in Ranchi — Samford Hospital — have debunked seven common myths about hypertension and straightened out the facts.

Myth 1: Hypertension Only Affects Older People

Fact: While hypertension is more common in older adults, it can affect people of all ages, including young adults and even teenagers. Factors like stress, poor diet, lack of exercise, obesity, and genetics contribute to high blood pressure at any age. Studies show that urban lifestyles, increased consumption of processed foods, and sedentary habits have led to a rise in hypertension cases among younger Indians.

Myth 2: High Blood Pressure Always Has Symptoms

Fact: Hypertension is often called the “silent killer” because it typically has no noticeable symptoms. Many people do not realize they have high blood pressure until they suffer from complications like heart attacks, strokes, or kidney disease. The only way to know if you have hypertension is to check your blood pressure regularly, especially if you have risk factors like a family history of hypertension, obesity, or high stress levels.

Myth 3: If You Feel Fine, You Don’t Need to Monitor Blood Pressure

Fact: Since hypertension does not always cause symptoms, feeling fine doesn’t mean your blood pressure is normal. Doctors from the best cardiology hospital in Ranchi — Samford Hospital — suggest regular monitoring to detect high blood pressure early and take necessary steps to manage it. Home blood pressure monitors are affordable and easy to use, making it convenient for people to track their readings.

Myth 4: Hypertension Is Not a Serious Condition

Fact: Uncontrolled high blood pressure can lead to severe complications, including heart disease, stroke, kidney failure, and even vision loss. Hypertension is one of the leading causes of cardiovascular diseases in India. Managing it properly through lifestyle changes and, if needed, medication can significantly reduce these risks.

Myth 5: Reducing Salt Intake Is Enough to Control Hypertension

Fact: While lowering salt intake helps manage high blood pressure, it is not the only factor to consider. A balanced approach, including a healthy diet, regular exercise, stress management, and avoiding smoking and excessive alcohol consumption, is essential for effective hypertension control. The DASH (Dietary Approaches to Stop Hypertension) diet, which includes fruits, vegetables, whole grains, and lean proteins, is recommended for managing blood pressure.

Myth 6: You Should Stop Taking Medication Once Your Blood Pressure is Normal

Fact: Many people stop taking their prescribed blood pressure medication once their readings are normal, assuming they are “cured.” However, hypertension is a chronic condition that requires ongoing management. Stopping medication without a doctor’s guidance can lead to dangerous spikes in blood pressure. If lifestyle changes help lower your blood pressure, your doctor may adjust your medication, but it should never be done without medical supervision.

Myth 7: Herbal Remedies and Home Remedies Can Cure Hypertension Completely

Fact: While certain herbal and home remedies, such as garlic, amla (Indian gooseberry), and hibiscus tea, may support blood pressure management, they cannot replace medical treatment. Scientific studies on many herbal remedies are still limited. Relying solely on home remedies without medical supervision can be risky. Always consult a doctor before incorporating herbal treatments into your routine, especially if you are on medication, says our specialist at Samford hospital, one of the best hospitals in Ranchi.

Hypertension and Its Common Causes

Hypertension is a condition in which the force of blood against the walls of the arteries is consistently too high. A normal blood pressure reading is around 120/80 mmHg, and anything above 140/90 mmHg is considered high. If left untreated, hypertension can lead to serious health problems, including heart disease, stroke, and kidney failure.

Common Causes of Hypertension:

  1. Unhealthy Diet — Excess salt intake, processed foods, and high-fat diets contribute to high blood pressure.
  2. Lack of Physical Activity — A sedentary lifestyle weakens the heart and leads to poor circulation.
  3. Obesity — Excess weight puts additional pressure on the heart and arteries.
  4. Stress — Chronic stress can lead to elevated blood pressure levels over time.
  5. Genetics — A family history of hypertension increases the likelihood of developing the condition.
  6. Smoking & Alcohol Consumption — These habits damage blood vessels and elevate blood pressure.
  7. Underlying Health Conditions — Diabetes, kidney disease, and hormonal disorders can contribute to high blood pressure.

Final Thoughts

Hypertension is a manageable condition, but misinformation can prevent people from taking the right steps. Regular monitoring, a healthy lifestyle, and proper medical guidance from doctors consulting at the best super speciality hospital in Ranchi are crucial for maintaining normal blood pressure. By debunking these myths, we hope more people take hypertension seriously and make informed choices for their health. If you or a loved one has high blood pressure, don’t hesitate to consult a healthcare professional for the best management plan.