A Multispecialty Consensus on Individualized Treatment Strategies for Hypertension Phenotypes and Comorbidities

Abstract

Hypertension (HTN) remains a leading contributor to global morbidity and mortality, often coexisting with major comorbidities such as diabetes, chronic kidney disease (CKD), coronary artery disease (CAD), heart failure (HF), and obesity. In India, a significant proportion of hypertensive individuals remain undiagnosed or inadequately treated. This multispecialty consensus provides comprehensive, evidence-based recommendations for individualized HTN management tailored to specific phenotypes and comorbidities. Developed through structured expert panel discussions and a review of international and national guidelines, the consensus emphasizes out-of-office blood pressure (BP) monitoring, phenotype recognition (e.g., white-coat, masked, nocturnal HTN), and early detection of target organ damage. The document outlines practical algorithms and a therapeutic wheel to guide antihypertensive therapy based on patient-specific factors, promoting use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), beta-blockers (BB), and diuretics, as per clinical context. Special considerations are provided for managing HTN in young adults, patients with tachycardia, stroke, and respiratory disorders. The consensus also advocates for lifestyle modifications, treatment adherence, and multidisciplinary care to improve BP control and long-term outcomes. By promoting a holistic, patient-centered approach, this consensus aims to bridge gaps in clinical practice and standardize the management of HTN in diverse healthcare settings.