API & ICP Unveil New Hypertension Guidelines For Indian Patients With Diabetes

The Association of Physicians of India (API) and the Indian College of Physicians (ICP) introduced new guidelines for managing hypertension in patients with Type 2 Diabetes Mellitus (T2DM) on Monday. 

Hypertension and diabetes are prevalent lifestyle diseases in India, with over 50 per cent of hypertensive patients also diagnosed with T2DM. This overlap increases the risk of cardiovascular and renal complications, making effective management essential. The guidelines emphasise the importance of region-specific protocols due to the differences in clinical challenges and drug responses between Indian and Western populations.

 Jyotirmoy Pal, President-Elect (2025) of API, stated, “While global guidelines offer a general framework for managing hypertension in T2DM, Indian and Southeast Asian populations face unique challenges. Our guidelines address these issues with a focus on early detection, comprehensive assessment, and a multi-faceted treatment approach.”

The new guidelines advocate for a multi-pronged strategy, including:

• Dual Antihypertensive Therapy: Combining Angiotensin Receptor Blockers (ARBs) with newer Calcium Channel Blockers (CCBs) like Cilnidipine for enhanced BP control and protection against cardiovascular complications.

• Advanced Detection Methods: Emphasizing the use of multiple techniques to detect and measure hypertension, including home BP monitoring.

• Lifestyle Modifications: Integrating yoga as an adjunct therapy to improve treatment outcomes for hypertension in T2DM patients.

Milind Nadkar, President of API, highlighted, “The integration of lifestyle modifications, including yoga, into the management protocol represents a holistic approach to treating hypertension. Yoga's benefits extend beyond physical health, contributing to overall well-being.”

The guidelines also recommend regular screening for microalbuminuria to monitor kidney function and cardiovascular risk, along with the use of specialised risk scores tailored for diabetic patients.

R.K. Singhal, Dean of ICP, noted, “Our focus on Cilnidipine and RAS blockers is based on their proven efficacy in managing diabetic kidney complications. The inclusion of newer anti-diabetic agents like SGLT2 inhibitors and GLP-1 receptor agonists further supports glycemic control and vascular protection.”

Healthcare practitioners are encouraged to adopt these guidelines to improve patient care. The detailed guidelines are published in the Journal of Association of Physicians of India (JAPI) and are available for reference, the API stated.