European Journal of Cardiovascular Medicine

Heart failure (HF) is a progressive clinical syndrome characterized by the inability of the heart to efficiently perform its circulatory function. The burden of HF has been increasing globally, including in India, leading to higher mortality rates, hospitalizations, and diminished quality of life. The incidence of HF in India is expected to rise due to factors such as an aging population, increased cardiovascular risk factors, and the persistence of diseases like rheumatic heart disease. Despite advances in medical therapy, HF continues to impose a significant healthcare and economic burden.

To understand the underlying substrate of hypertension leading to HF, a group of 20 experts from various regions of India participated in a national-level expert panel meeting. The experts reviewed scientific literature and discussed the management of hypertension, dyslipidemia, and HF in the Indian context. Consensus statements were developed based on the discussions and approved by all participating experts.

Key findings include early onset of end-organ damage and microalbuminuria in Indian hypertensive patients, elevated sympathetic overactivity in certain subgroups, and the efficacy of combination therapies and calcium channel blockers. The management of dyslipidemias was found to be suboptimal, with physician inertia and concerns about side effects being barriers to guideline-directed therapy. Recommendations were made to improve physician education and patient awareness. In HF management, challenges were identified, and strategies were proposed to optimize guideline-directed medical therapy and implement newer therapies such as angiotensin receptor-neprilysin inhibitors (ARNIs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors. This consensus document provides valuable insights and recommendations for managing hypertension, dyslipidemia, and HF in the Indian population, with the potential to improve patient outcomes and reduce the burden of HF.