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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
PubMed

Insights

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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