Asian management of hypertension: Current status, home blood pressure, and specific concerns in Indonesia

Area of Science:

• Cardiology
• Public Health
• Health Economics

Background:

• Hypertension affects over a third of Indonesians, with high rates of uncontrolled blood pressure (BP) and comorbidities among treated patients.
• Home blood pressure monitoring (HBPM) is recommended by the Indonesian Society of Hypertension (2019) and widely by physicians for hypertension management.
• Barriers to HBPM adoption in Indonesia include device cost, perceived unreliability, and lack of procedural knowledge.

Purpose of the Study:

• To assess the current landscape of hypertension management in Indonesia.
• To identify challenges and opportunities for improving home blood pressure monitoring (HBPM) adoption.
• To highlight the need for increased awareness and adherence to therapy for effective hypertension control.

Main Methods:

• Review of current hypertension prevalence and treatment patterns in Indonesia.
• Analysis of factors influencing the use of home blood pressure monitoring (HBPM).
• Examination of common antihypertensive agents and combination therapies used.

Main Results:

• Over one-third of the Indonesian population has hypertension, with nearly two-thirds of treated patients experiencing uncontrolled BP.
• Angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs) are common antihypertensive agents, varying by age group.
• Combination therapy (CCB + angiotensin receptor blocker) is prevalent, used by 41%-42% of patients.

Conclusions:

• Despite recommendations, HBPM use in Indonesia is hindered by cost and trust issues.
• The phasing out of mercury sphygmomanometers may promote digital device adoption and HBPM.
• Addressing economic impacts requires enhanced disease awareness and therapy adherence for strict BP control.