India Consensus on Hypertension guidelines
Journal Title: MedPulse -International Medical Journal - Year 2019, Vol 7, Issue 1
Abstract
panel discussion and collective opinion on India consensus (IC) on the revised International guideline on hypertension to chart out the management plan was the objective. The panel recommended IC statements on setting up of target blood pressure (BP), factors to be considered, charted out measures for prevention, detection, management, treatment response, associated risks, and other therapeutic outcomes. Noting a lack of evidence-based data from the Indian population, the panel emphasized the need for more awareness among physicians to report to the national registry. The panel proposed widespread screening, catching them young through early screening, diagnosis using ambulatory or home BP monitors (ABPM/HBPM), wider use of the automated office BP manometers and digital manometers for self-monitoring. Identification of high-risk population, initiation of treatment with low dose two-drug therapy/triple therapy if unresponsive to two drugs, regular follow-up, with one visit during the onset of summer and winter, respectively,was recommended. Use of angiotensin receptor blockers/angiotensin-converting enzyme inhibitors along with a diuretic and/or calcium channel blockers was recommended as standard care and suggested individualizing the treatment strategy. Involvement of nurses, pharmacists, and family members to promote treatment adherence was encouraged. Implications: Screening must start early (late teens) and aim to identify & prevent microvascular changes. A lower target BP ≤ 120/80 mmHg and ≤130/80 mmHg be set for those aged ≤60 years and ≥60 years, though recommended, must be individualized. Use of ABPM and/HBPM for diagnosis of hypertension, two drugs from the initial stage is recommended. Importance of patient education, counselling in continuing regular follow up and treatment adherence was emphasized. There is a need for revising the Indian guidelines for hypertension. Conclusion: Revised the hypertension guidelines globally, have lowered the normal and optimal Blood pressure. Guidelines issued by European society of Hypertension are more practical to follow but geographical, cultural differences mandate revisions in Indian Hypertension guideline as well. A detailed assessment for the confirmation of the diagnosis, appropriate use of combination medications/fixed drug combinations, prevention of disease complications including minimizing/delaying the development of target organ damage, life style changes, treatment compliance are the focus areas in the disease management.
Authors and Affiliations
Selvamani S, Latchumanadhas K, Arup D Biswas, Suvro Banerjee, Mohan JC, Mahesh K Shah, Viswanathan M
Keywords
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