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A Multispecialty Consensus on Individualized Treatment Strategies for Hypertension Phenotypes and Comorbidities
Gurpreet S Wander1, Kamlesh Tewary2, A Muruganathan3
1Professor and Head, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
The Journal of the Association of Physicians of India
|September 16, 2025
Summary
This consensus offers evidence-based guidelines for individualized hypertension management in India, focusing on phenotype, comorbidities, and patient-centered care to improve blood pressure control.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Hypertension (HTN) is a major global health issue, frequently associated with diabetes, chronic kidney disease (CKD), coronary artery disease (CAD), heart failure (HF), and obesity.
- In India, a substantial number of individuals with hypertension are undiagnosed or undertreated, highlighting a critical need for improved management strategies.
Purpose of the Study:
- To provide comprehensive, evidence-based recommendations for individualized hypertension management in India.
- To address the challenges of hypertension control by tailoring treatment to specific patient phenotypes and comorbidities.
Main Methods:
- Development of consensus through structured expert panel discussions and review of international and national guidelines.
- Emphasis on out-of-office blood pressure (BP) monitoring and recognition of various hypertension phenotypes (e.g., white-coat, masked, nocturnal HTN).
- Utilization of practical algorithms and a therapeutic wheel for guiding antihypertensive therapy based on patient-specific factors.
Main Results:
- Recommendations include prioritizing angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), beta-blockers (BB), and diuretics based on clinical context.
- Special considerations are outlined for managing hypertension in specific populations, including young adults, patients with tachycardia, stroke, and respiratory disorders.
- Advocacy for lifestyle modifications, treatment adherence, and multidisciplinary care to enhance BP control and long-term outcomes.
Conclusions:
- The consensus promotes a holistic, patient-centered approach to hypertension management.
- Aims to standardize hypertension care and bridge gaps in clinical practice across diverse healthcare settings in India.
- Emphasizes early detection of target organ damage and individualized therapeutic strategies for better patient outcomes.
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