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Current Practice of Hypertension in India: Focus on Blood Pressure Goals

Jagdish S Hiremath1, Vijay M Katekhaye2, Vijay S Chamle3

  • 1Interventional Cardiologist, Department of Cardiology, Ruby Hall Clinic , Pune, Maharashtra, India .

Journal of Clinical and Diagnostic Research : JCDR
|February 18, 2017
PubMed

Insights

Indian physicians often adopt lower blood pressure (BP) goals than recommended by Joint National Committee (JNC) guidelines for hypertension management. Greater physician awareness of updated recommendations is crucial for effective hypertension control.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Public Health

Background:

  • Blood pressure (BP) management guidelines for hypertension (HTN) in elderly patients and those with comorbidities like diabetes mellitus (DM) and chronic kidney disease (CKD) present variations.
  • Understanding current physician practices in India regarding BP goals for hypertension is essential for aligning clinical care with evidence-based recommendations.

Purpose of the Study:

  • To investigate the blood pressure goals and hypertension management practices currently followed by physicians in India.
  • To identify the most frequently referenced hypertension guidelines among Indian physicians.

Main Methods:

  • A cross-sectional, observational survey was conducted among physicians at the 66th annual conference of the Cardiological Society of India (CSICON-2014).
  • A structured questionnaire assessed physicians' BP goals and HTN management practices.
  • Descriptive statistics were used to analyze the collected data from voluntarily participating physicians.

Main Results:

  • The Joint National Committee (JNC) guidelines were most frequently referenced (63.85%), followed by Indian HTN guidelines (14.23%).
  • For elderly patients (≥60 years), 43.46% aimed for a BP goal of <140/90mmHg.
  • In Type 2 Diabetes Mellitus (T2DM) with HTN, 61.92% targeted <130/80mmHg. In CKD with proteinuria, 68.85% targeted <130/80mmHg.
  • Ambulatory BP Monitoring (ABPM) was used in less than 5% of patients by most physicians (71.93%).

Conclusions:

  • Indian physicians' current clinical practice often involves lower BP goals than those recommended by the most referenced JNC guidelines.
  • There is a need to enhance physicians' awareness regarding updated recommendations for hypertension management.
  • Discrepancies in BP targets highlight the importance of continuous medical education and guideline dissemination.
Abstract

Keywords:
Ambulatory blood pressure monitoringBeta blockerDiabetesHypertension guidelines

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