Blood pressure control among Indians with hypertension: the I-Target survey

Hypertension, a major cardiovascular disease risk factor, is increasing in India. Though several studies have studied the prevalence and causes of hypertension in India, only few have examined the control of blood pressure (BP) among people with hypertension. The I-Target survey was carried out to assess the extent of BP control among Indian patients with hypertension receiving antihypertension medications. A total of 270 physicians from four zones of India included 3402 patients with hypertension who were undergoing treatment. They collected information on BP levels, current medication and presence of other risk factors, and determined the average systolic and diastolic BP in hypertensive patients. Of the study population, 1435 patients (42.2%) had diabetes and 787 (23.1%) had coronary artery disease (CAD). Overall, 70.5% patients did not reach target systolic BP (SBP) goal and 36.9% patients did not reach diastolic BP (DBP) goal. Only 27.3% patients had both SBP and DBP under control. Among patients with diabetes, 81.1% had uncontrolled SBP and 76.2% had uncontrolled DBP. In patients with CAD, 71.8% of SBP and 38.5% of DBP readings were outside the recommended target BP levels. Regardless of comorbidities-hypercholesterolaemia, myocardial infarct, metabolic syndrome, stroke, diabetic nephropathy or obesity--the average SBP and DBP were higher than target BP levels. Among patients with hypertension, control of BP to recommended targets was very poor, only to the extent of 27.3%. The average BP of hypertensive patients with comorbidities like diabetes and CAD was also higher than the BP goals recommended by international and local guidelines. Thus, there is an urgent need to increase awareness among patients with hypertension and to ensure that BP goals are achieved.