Key result
Young hypertensive patients achieve ~65% target BP control despite frequent guideline-discordant monotherapy and beta-blocker use.
Why the study?
India has a high burden of premature cardiovascular disease driven by early-onset hypertension, but real-world data on hypertension management in young Indian adults remain limited.
Cross-Sectional (n=8,195)
Yes
Real-world management of early-onset hypertension in India frequently deviates from global guidelines, characterized by an overreliance on monotherapy and beta-blockers, underscoring the need to adopt structured interventions to improve long-term outcomes.
Answers are grounded in this paper and cite their sources.
May signal practice gaps in young Indian hypertensives; leaves open whether closing monotherapy deviations improves outcomes.
BACKGROUND: India has a high burden of premature cardiovascular disease, with early-onset hypertension being a key driver. However, real-world data on hypertension management in young Indian adults remain limited. OBJECTIVES: To evaluate physician practices in diagnosing and treating hypertension among Indian adults aged 18-45 years, with a focus on guideline concordance, lifestyle interventions, and comorbidity-specific treatment choices. METHODS: A nationwide, web-based survey of 3,289 physicians was conducted from December 2022 to August 2023 using a 22-point questionnaire. An additional module collected anonymized data on 8,195 hypertensive patients. Analyses included descriptive statistics and logistic regression to assess factors associated with BP control (<130/80 mmHg). RESULTS: Most physicians (66 %) managed over five young hypertensive patients monthly. While lifestyle advice was commonly given (>80 %), no structured programs or adherence tracking were used. Monotherapy was initiated in 49 % of cases, with β-blockers prescribed in 32 %, despite guidelines favoring dual therapy with ARBs, ACE inhibitors, or CCBs. Only 27 % of physicians reported BP control in >50 % of their patients. Among patients, 65 % achieved target BP; 34.6 % had target organ damage. Positive predictors of BP control included male gender, private-sector care, and fruit/vegetable intake, while longer disease duration and target organ damage were associated with poorer control. CONCLUSIONS: Hypertension management in young Indian adults shows substantial deviations from global guidelines. Overuse of monotherapy, β-blockers, and lack of structured lifestyle support underscore the need for practice transformation to improve long-term cardiovascular outcomes.
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Roy et al. (2025) conducted a cross-sectional in Hypertension (n=8,195). Real-world hypertension management was evaluated on Achievement of target blood pressure (<130/80 mmHg). Among 8,195 young hypertensive patients in India, 65% achieved target blood pressure (<130/80 mmHg), but real-world practices showed significant guideline deviations, including the overuse of monotherapy (49%) and β-blockers (32%).
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