From the Research
Hypertension in Indians is classified similarly to international standards, with some adaptations for the Indian population, and according to the most recent guidelines, normal blood pressure is below 120/80 mmHg, prehypertension is 120-139/80-89 mmHg, Stage 1 hypertension is 140-159/90-99 mmHg, and Stage 2 hypertension is ≥160/≥100 mmHg, as supported by 1. The JNC (Joint National Committee) classification, particularly JNC 8, focuses on treatment thresholds rather than strict categories. For Indians, treatment is generally recommended when BP exceeds 140/90 mmHg in most adults, with a lower threshold of 130/80 mmHg for those with diabetes or chronic kidney disease, as indicated by 1. Some key points to consider in the classification and management of hypertension in Indians include:
- Indians may develop hypertension at lower BMI levels compared to Western populations due to genetic factors, higher salt intake, and increased visceral adiposity.
- Initial treatment typically includes lifestyle modifications (reduced salt intake, increased physical activity, weight management) along with medications like calcium channel blockers, ACE inhibitors, ARBs, or thiazide diuretics, as recommended by 1.
- Combination therapy is often needed earlier in Indians due to more severe and resistant hypertension.
- Regular monitoring is essential, with home blood pressure monitoring recommended alongside clinical visits to ensure proper control and medication adherence. It's also important to note that the choice of antihypertensive medication may depend on individual patient characteristics and comorbidities, as discussed in 2 and 3. Overall, the classification and management of hypertension in Indians should be based on the most recent and highest-quality evidence, with a focus on individualized treatment and regular monitoring to improve outcomes and reduce morbidity and mortality, as emphasized by 1.