When did that question ever wait for an answer? I always liked 'how do you do?' as a greeting as the only proper answer was perfect symmetry: 'how do you do?' That exchange seems almost to have faded away, dating me to the age of the steam trains I can still dimly visualise pulling out of Paddington in 1967.
A friend used always to answer 'how are you?' with a terse 'yes!'. I think he figured that the question was equivalent to the kind of 'hand-shaking' signals modems exchange when they first connect. The answer 'yes!' was hardy ever noticed. The question was merely a necessity to be endured and a preliminary to any conversation of substance. If I remember correctly, once two modems have established a link in this way, they next 'negotiate' to establish a rate of information flow that suits them both.
Perhaps 'how are you?' performs the same function. There must be a hundred ways of saying 'fine, thanks' or even 'yes', all of them giving different subliminal messages about an individual's mood and receptivity.
The temptation to answer 'how are you?' with a detailed description of medical symptoms is probably best avoided, although it's sometimes worth it for the look of complete horror on your unfortunate victim's face. Best avoided also is the urge to respond with existential mutterings of the metaphysical variety, although I have found these can be very effective when dealing with persistent telephone sales people.
Anyway, how are you these days?