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Indian guidelines on hypertension-IV (2019)

Journal of Human Hypertension volume 34, pages 745–758 (2020)Cite this article

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Hypertension is a major contributor to cardiovascular morbidity and mortality worldwide and in India. In view of the unique geographical and climatic conditions, ethnic background, dietary habits, literacy levels, and socioeconomic variables in India, the Association of Physicians of India (API), Cardiological Society of India (CSI), Indian College of Physicians (ICP), and Hypertension Society of India (HSI) developed the “First Indian Guidelines for the Management of Hypertension—2001.” [1] The second and third versions of the guidelines were published in 2007 (http://www.apiindia.org/hsi_guideline_ii.html) and 2013 [2].

We now present the fourth edition of the Indian Guidelines on Hypertension (IGH-IV). This update incorporates recent changes in the diagnosis and management of hypertension, including change in definition of hypertension by the American College of Cardiology/American Heart Association (ACC/AHA), changes in target BP [3], greater use of home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), reduced interest in renal angioplasty and renal denervation therapy and use of spironolactone for resistant hypertension. New epidemiological data on hypertension and hypertension mediated organ damage (HMOD) have also been included. The guideline has been harmonized with guidelines from other organizations released recently [4,5,6,7].

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Fig. 1: Prevalence of hypertension in India over last four decades.
Fig. 2: Changes in leading causes of DALY in India from 1990 to 2016.
Fig. 3: Approach to Pharmacotherapy of hypertension.
Fig. 4: Approach to management of hypertension.

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Authors and Affiliations

  1. Consultant physician, Bhatia hospital, Saifee hospital, Sir H.N. reliance hospital and SL Raheja hospital, Mumbai, Maharashtra, India

    Siddharth N. Shah

  2. Banarsidas Chandiwala Institute of Medical Sciences, New Delhi, India

    Y. P. Munjal

  3. Seth GS Medical College and KEM Hospital College, Mumbai, Maharashtra, India

    Sandhya A. Kamath

  4. Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India

    Gurpreet S. Wander

  5. Jaslok Hospital, Breach Candy Hospital, Bhatia Hospital, Mumbai, Maharashtra, India

    Nihar Mehta

  6. Department of Medicine, Medical College, Kolkata, West Bengal, India

    Sukumar Mukherjee

  7. Bombay Hospital Institute of Medical Sciences Mumbai, Mumbai, Maharashtra, India

    Ashok Kirpalani

  8. Department of Medicine Sunder Lal Jain Hospital, Delhi, India

    Pritam Gupta

  9. Bombay Hospital, Mumbai, India

    Hardik Shah

  10. Rohit Diabetes Centre, Jeevan Vikas Kendra Hospital, Mumbai, Maharashtra, India

    Ragini Rohatgi

  11. Sir J J group of Hospitals, Mumbai, Maharashtra, India

    Aspi R. Billimoria

  12. Rangadore Memorial Hospital, Bangalore, Karnataka, India

    M. Maiya

  13. BM Birla Heart Research Centre Kolkata, Kolkata, West Bengal, India

    Mrinal Kanti Das

  14. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

    Kewal C. Goswami

  15. Rajan Hospital, Yamuna Nagar, Haryana, India

    Rajan Sharma

  16. Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India

    Mohan M. Rajapurkar

  17. North Delhi Diabetes Centre New Delhi, New Delhi, India

    Rajeev Chawla

  18. Diabetes Care & Hormone Clinic, Ahmedabad, Gujarat, India

    Banshi Saboo

  19. The George Institute for Global Health, UNSW, New Delhi, India

    Vivekanand Jha

  20. The George Institute for Global Health, University of Oxford, Oxford, UK

    Vivekanand Jha

  21. Manipal Academy of Higher Education, Manipal, India

    Vivekanand Jha

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  1. Siddharth N. Shah
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  2. Y. P. Munjal
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Correspondence to Gurpreet S. Wander.

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Shah, S.N., Munjal, Y.P., Kamath, S.A. et al. Indian guidelines on hypertension-IV (2019). J Hum Hypertens 34, 745–758 (2020). https://doi.org/10.1038/s41371-020-0349-x

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