InSH Consensus Guideline for the Management of Hypertension, 2023

Abstract

Hypertension is a global health concern, responsible for 10 to 12% of all cause mortality worldwide. In India, hypertension affects 32.6% of women and 38.7% of men over the age of 20 years. Its prevalence varies across wealth quintiles and states. 

With a mission of taking the forefront in the campaign to control elevated blood pressure and its associated complications across the Indian subcontinent, the Indian Society of Hypertension (InSH) took the responsibility of creating a clinical guideline inspired by the International Society of Hypertension framework (ISH) to better adapt the knowledge, best practices and recommendations to the Indian context. The unique challenges in the Indian context necessitate dedicated guidelines tailored for the country. The silent yet pervasive issues of high prevalence substantial undiagnosed cases of hypertension are compounded by limited patient awareness of hypertension's often symptomless nature and the absence of standardized nationwide guidelines. The country observes an alarming rise in mean systolic blood pressure and hypertension rates, particularly in rural areas, accompanied by geographical disparities favoring the more developed regions. Premature hypertension onset among the young and increasing mortality from hypertension-related conditions are sources of major concern. Patient awareness, treatment compliance, and control of hypertension remain suboptimal, with insufficient focus on strategies to minimize hypertension-mediated organ damage. The unequal allocation of resources at a country and state level further compounds the challenge. India's distinct socio-economic, geographical, and cultural diversity requires tailored strategies to avert the impending NCD pandemic, with hypertension and obesity at the forefront, particularly among the youth.