Management of hypertension across the cardiovascular-renal continuum

Abstract

A high incidence of cardiovascular risk misclassification and underestimation of high-risk patients prevails among primary care physicians. In addition, it has been observed that treatment goals of hypertension as recommended by guidelines are not followed in the primary healthcare setting. Therefore, there exists a large percentage of the population with uncontrolled hypertension in India. We aimed at developing a framework for the effective management of hypertension and cardiovascular-renal risk in the presence of comorbidities for clinicians/healthcare providers. An online advisory board meeting with eminent cardiologists from across India was conducted to understand their perspectives on the management of hypertension across the cardiovascular-renal continuum. The outcomes of the meeting were summarized following a literature review of cardiorenal disorders, stroke, and heart failure risk in hypertensive patients. Furthermore, optimal treatment of hypertension in patients with a high risk of coronary artery disease, stroke, and chronic kidney disease and the choice of angiotensin receptor blockers in these patients were suggested. The advisory board meeting provided management strategies for patients with hypertension across the cardiovascular-renal continuum considering the increased risk of heart failure and death in the Indian setting.