Cardinal aspects of treatment to control hypertension in India-2022 (CATCH 22): A survey on arterial hypertension management in young Indian adults: A report from cardiology society of India.

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.