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Management of Hypertension and Associated Comorbidities: An Expert Consensus Statement from India

H N Mishra1, Sadanand Shetty2, Arun Chopra3

  • 1Senior Consultant Interventional Cardiologist, Apollo Hospitals, Bhubaneswar, Odisha, India.

The Journal of the Association of Physicians of India
|September 16, 2025
PubMed

Insights

Managing hypertension in India is crucial due to rising prevalence and comorbidities. This expert consensus provides evidence-based guidance on blood pressure targets and antihypertensive strategies for high-risk patients to improve cardiovascular and renal outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Hypertension is a major global health issue, particularly in India, where it frequently coexists with type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), coronary artery disease (CAD), and metabolic syndrome (MetS).
  • Managing hypertension in patients with these comorbidities presents significant challenges, including varied blood pressure (BP) targets and the need for complex combination therapies to address conditions like albuminuria and acute coronary syndromes (ACS).

Purpose of the Study:

  • To provide standardized, evidence-based recommendations for hypertension management in India.
  • To guide optimal blood pressure targets and antihypertensive strategies for high-risk patient populations.
  • To address clinical practice inconsistencies and improve patient outcomes through expert consensus.

Main Methods:

  • Expert consensus development based on current evidence.
  • Review of optimal antihypertensive strategies, including renin-angiotensin-aldosterone system blockers, calcium channel blockers (CCBs), beta-blockers (BBs), and sodium-glucose cotransporter-2 inhibitors.
  • Consideration of combination therapies for improved cardiovascular (CV) and renal outcomes.

Main Results:

  • The consensus outlines specific guidance on blood pressure targets for high-risk individuals.
  • It details the role of various antihypertensive drug classes and combination therapies in managing complex hypertension.
  • Recommendations focus on individualized treatment approaches to enhance CV and renal protection.

Conclusions:

  • Standardized, evidence-based recommendations are essential for effective hypertension management in India.
  • Individualized treatment strategies incorporating guideline-directed medical therapy are key to improving outcomes.
  • This expert consensus aims to enhance early intervention and optimize patient care for hypertension and its associated comorbidities.

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