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. 2016 Dec;10(12):OC25-OC28.
doi: 10.7860/JCDR/2016/21783.8999. Epub 2016 Dec 1.

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

Jagdish S Hiremath  1 , Vijay M Katekhaye  2 , Vijay S Chamle  3 , Rishi M Jain  4 , Amit I Bhargava  5
Affiliations

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

Jagdish S Hiremath et al. J Clin Diagn Res. 2016 Dec.

Abstract

Introduction: Recommended Blood Pressure (BP) goals in elderly and those with co-morbid conditions like Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) vary in different Hypertension (HTN) management guidelines.

Aim: To understand currently followed BP goals and practices among the physicians involved in management of HTN in India.

Materials and methods: A cross-sectional, observational survey was conducted at 66th annual conference of Cardiological Society of India (CSICON-2014, Hyderabad). A structured questionnaire related to the BP goals and HTN practices was provided and responses from voluntarily participating physicians were collected. Data was analysed with descriptive statistics.

Results: Two-hundred sixty physicians completed this survey. In their routine clinical practice, physicians most frequently referred to Joint National Committee (JNC) guidelines (63.85%) followed by Indian guidelines on HTN (14.23%). In patients aged 60 years and above, BP goal <140/90mmHg and <150/90mmHg was aimed by 43.46% and 33.85% of the physicians respectively. In HTN with Type 2 DM (T2DM), most physicians (61.92%) had a BP goal of <130/80mmHg. A target BP <130/80mmHg was aimed by 48.08% physicians in CKD without proteinuria and 68.85% physicians in CKD with proteinuria. In newly diagnosed hypertensives, treatment modification was practiced after 15, 20 and 30 days by 37.31%, 16.15% and 35.77% of the physicians respectively. Beta-blockers were considered as third-line agents in HTN without co-morbidities by 45% physicians. Ambulatory BP Monitoring (ABPM) is practiced only in few patients (<5%) by most (71.93%) physicians.

Conclusion: In practice, Indian physicians follow lower BP goals when compared to the recommendations from the most referred JNC guidelines. Increasing physicians' awareness to the changes in recommendations is the need.

Keywords: Ambulatory blood pressure monitoring; Beta blocker; Diabetes; Hypertension guidelines.

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Figures

[Table/Fig-3]:
[Table/Fig-3]:
Guidelines commonly followed in clinical practice. JNC-8: Joint National Committee-8, ASH-ISH: American Society of Hypertension and International Society of Hypertension, ESH-ESC: European Society of Hypertension-European Society of Cardiology, NICE: National Institute for Health and Care Excellence, NA – Not available.
See this image and copyright information in PMC

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