Current practice toward the use of antihypertensive agents in the management of hypertension – A cross-sectional study among Indian physicians

Abstract

Objective: The objective of this study was to assess current practices and usage patterns of antihypertensive medications in managing hypertension (HTN) in India. Materials and Methods: A cross-sectional, observational digital study was conducted among health-care practitioners (HCPs) across India (November 2022–March 2023). Results: A total of 792 HCPs (cardiologists, consulting, and general physicians) participated in this study. According to 63.38% of HCPs, 20–50 essential HTN patients seek consultation weekly. The majority of patients were in the age range of 40–60 years (84.09%). A total of 67.55% of HCPs mentioned that systolic blood pressure (BP) ranged between 140 and 160 mmHg. Type 2 diabetes mellitus was the most common comorbidity among hypertensive patients (84.09%). In total, 53.79% and 37.37% of HCPs preferred angiotensin receptor blockers (ARBs)/angiotensin-converting enzyme and calcium channel blockers (CCBs) as the first choice of antihypertensive agents. The majority of HCPs (>69%) preferred prescribing a triple-drug fixed-dose combination (FDC) of CCBs + ARB + diuretics in hypertensive patients with coronary artery disease (CAD) and resistant HTN. The majority (89.90%) of HCPs preferred prescribing FDC of CCBs over monotherapy. Amlodipine (>55%) followed by cilnidipine (>32%) were preferred CCBs for young and older hypertensive patients. In patients with essential HTN without any CVD, amlodipine (72.85%) was the preferred CCB. Vascular selectivity (59.09%) and longer half-life (54.55%) were important factors for prescribing CCBs. Resistant HTN, inadequate BP control with monotherapy, and the presence of CAD were all (62.63%) important considerations for FDC with CCBs. The underutilization of CCBs in managing HTN (63.88%) was highlighted. Conclusion: Overall responses provide a comprehensive overview of the prevailing perception and the usage patterns of antihypertensive agents employed by HCPs in India.