Expert Opinion on Hypertension Management: An Indian Observational Study

Abstract

Background: Hypertension prevalence in India is increasing significantly in last decade. An observational study was conducted to assess prevalence of Hypertension, its determinants like patient adherence to diet, exercise and pharmacotherapy in routine clinical practice. Methodology: A cross sectional, questionnaire based study was conducted to collect opinion among doctors in cardiology practice across India between January to April 2017. Convenient sampling method was used. Results: A questionnaire booklet titled 'HEART study (Experts Opinion on HypertEnsion And its tReatmenT)' was distributed to doctors who had given written informed consent to participate in the study. 442 completely filled booklets were assessed. The HEART study results highlights that 78% of doctors diagnosed >20 new cases of hypertension every month. Patient's adherence to physical activity and diet was rated as poor by 70% of doctors.. 67% respondents prescribed Angiotensin Receptor Blockers (ARB) and Telmisartan (52.7%) was most opted ARB followed by Olmesartan (24.5%) and Losartan (21%), Valsartan (1.8%). Majority of doctors (92%) opined that >60% of hypertensive patients require second drug to achieve goal BP and >1/5th of patients require third drug. Among hypertensive smokers, study participants chose Telmisartan (53%), followed by amlodipine (36%). Dyslipidemia (46%) was most common co-morbid condition seen by Doctors and 70.6% of doctors prescribed Atorvastatin for dyslipidemia. All Doctors opined that patients' awareness to hypertension was poor and counseling of patient's at least once a month was preferred by 92% of doctors. Conclusion: The 'HEART' study data demonstrates that current rates for awareness on hypertension, compliance to treatment is low. Telmisartan is commonly prescribed ARB by Doctors and Dyslipidemia is most common co-morbid condition witnessed in their practice. Increasing number of patients requires >1 drug for achieving goal BP. Emphasis on regular patient counseling on lifestyle modification, medication adherence and follow-up helps in better management of hypertension.