Hypertension and beyond in Indian clinical practice study: a nationwide survey assessing knowledge, attitude and practices of physicians

Background: Hypertension is the leading cause for the ever-increasing burden of mortality due to stroke and cardiovascular diseases (CVD). Treatments are complicated due to comorbidities and can lead to patient noncompliance. Patients with low existing cardiovascular risk are prone to have higher lifetime cardiovascular risk, which timely assessment necessary. Methods: A digital cross-sectional survey questionnaire about knowledge, attitude and practice habits regarding cardiovascular risk assessment was administered to 400 physicians and cardiologists across India. The questionnaire assessed various topics such as practice of hypertension diagnosis and treatment based on guidelines, cardiovascular risk calculators, occurrence of comorbidities and patient awareness on cardiovascular risk prevention. Results: Out of the 400 physicians, 398 completed the survey. About 52% physicians considered presence of multiple risk factors as vital for having cardiovascular risk. American college of cardiology/American heart association (ACC/AHA) calculator was preferred by 51.6% study participants. Cardiovascular risk estimation was vital for treatment-related decision-making according to 71% participants, while only 7.7% participants calculated cardiovascular risk in >90% of their patients. Approximately 44% survey participants calculated cardiovascular risk in hypertensive patients with 2 additional risk factors, while 5.6% calculated it in >70% hypertensive patients without comorbidities. About 46.6% participants reported that 30%-50% of their patients were on fixed-dose combinations of two antihypertensive medications. Conclusions: Findings from the study indicate predisposition of medical professionals towards having a risk assessment tool designed for the Indian population to timely assess and forestall long-term effects of cardiovascular risk in hypertensive patients.