Position statement on hypertension by Indian Society of Hypertension, 2023.

The Indian Society of Hypertension (InSH) highlights the urgency for India-specific guidelines on hypertension management. Hypertension affects over one billion people worldwide, with India bearing a significant burden due to its population, diversity, and demographics. In India, hypertension affects 21% of women and 24% of men, while pre-hypertension affects 39% of women and 49% of men. The prevalence of hypertension increases in the population with obesity. Even 7% of school-going children in India have hypertension, especially in urban and overweight children. However, awareness and control of hypertension in India are inadequate. Only 57% of women and 38% of men have been diagnosed with hypertension; among them, only a fraction receive appropriate medication. The overall control of hypertension stands at 15%, with regional variations. Hypertension significantly contributes to cardiovascular and renal diseases, and better detection and treatment could reduce their impact in India. At the total population level, reducing systolic blood pressure (SBP) by 2 mm Hg may significantly affect cardiovascular disease. Considering the unique challenges faced in India, the InSH stresses the importance of a tailored approach to hypertension management. They plan to disseminate guidelines through practitioner training and patient awareness campaigns. These guidelines will cover screening, diagnosis, management, handling hypertension with other conditions, long-term follow-up, and patient education. In conclusion, this position paper calls for immediate action to improve hypertension management in India and alleviate the associated disease burden and mortality.

Management of diabetic dyslipidemia in Indians: Expert consensus statement from the Lipid Association of India.

In 2021 an estimated 74 million individuals had diabetes in India, almost all type 2 diabetes. More than half of patients with diabetes are estimated to be undiagnosed and more 90% have dyslipidemia that is associated with accelerated development of atherosclerotic cardiovascular disease (ASCVD). Patients of Indian descent with diabetes have multiple features that distinguish them from patients with diabetes in Western populations. These include characteristics such as earlier age of onset, higher frequency of features of the metabolic syndrome, more prevalent risk factors for ASCVD, and more aggressive course of ASCVD complications. In light of the unique features of diabetes and diabetic dyslipidemia in individuals of Indian descent, the Lipid Association of India developed this expert consensus statement to provide guidance for management of diabetic dyslipidemia in this very high risk population. The recommendations contained herein are the outgrowth of a series of 165 webinars conducted by the Lipid Association of India across the country from May 2020 to July 2021, involving 155 experts in endocrinology and cardiology and an additional 2880 physicians.