Assessing the dual challenge of hypertension and dyslipidemia comorbidity: a real-world need gap analysis on diagnosis, management, drug therapy and patient related factors
DOI:
https://doi.org/10.18203/2349-3933.ijam20260388Keywords:
Hypertension, Dyslipidemia, Cardiovascular risk, Patient adherence, India healthcare practicesAbstract
Background: Hypertension and dyslipidemia frequently coexist and significantly elevate the risk of cardiovascular disease (CVD) through shared mechanisms. Despite clear evidence supporting integrated management, real-world gaps persist in diagnosis, monitoring, and patient adherence.
Methods: This nationwide cross-sectional survey was conducted among 842 healthcare professionals (HCPs) across India to evaluate current clinical practices, challenges, and educational needs in managing this dual comorbidity. A structured 20-item questionnaire captured insights on comorbidity prevalence, diagnostic approaches, therapeutic practices, and barriers to optimal care.
Results: The survey revealed substantial coexistence of hypertension and dyslipidemia, with 40.2% of HCPs reporting dyslipidemia in 10-20% of hypertensive patients and 38.8% observing hypertension in 20-30% of dyslipidemic cases. Comorbidity was most prevalent in adults aged 45-60 years (51.9%). Lifestyle factors were the leading contributors (38.3%), followed by age-related factors (25.4%). Despite routine lipid panel use, early diagnosis was hindered by poor follow-up (24.6%), asymptomatic presentation (23.3%), and inadequate screening guidelines (23.0%). Poor patient adherence was identified as the major treatment challenge (54.7%), while guideline sufficiency was divided, with 45.5% rating them adequate and a similar proportion finding them only somewhat sufficient.
Conclusions: Overall, the findings highlight substantial unmet needs in the real-world management of hypertension with dyslipidemia. Strengthened patient education, structured lifestyle support programs, regular lipid testing, and enhanced clinician training may improve early detection and long-term outcomes. A more unified, patient-centered approach is essential to reducing the growing cardiometabolic burden in India.
Metrics
References
Johnson ML, Pietz K, Battleman DS, Beyth RJ. Prevalence of comorbid hypertension and dyslipidemia and associated cardiovascular disease. Am J Manag Care. 2004;10(12):926-32.
Tassew WC, Woldie SS, Ferede YA, Zeleke AM, Nigussie A. Dyslipidemia and associated factors among hypertensive patients in Ethiopia: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2025;25(1):367. DOI: https://doi.org/10.1186/s12872-025-04808-3
Borghi C, Fogacci F, Agnoletti D, Cicero AFG. Hypertension and Dyslipidemia Combined Therapeutic Approaches. High Blood Press Cardiovasc Prev Off J Ital Soc Hypertens. 2022;29(3):221-30.
Dalal JJ, Padmanabhan TNC, Jain P, Patil S, Vasnawala H, Gulati A. LIPITENSION: Interplay between dyslipidemia and hypertension. Indian J Endocrinol Metab. 2012;16(2):240-5. DOI: https://doi.org/10.4103/2230-8210.93742
Dalal J, Chandra P, Chawla R, Kumar V, Abdullakutty J, Natarajan V, et al. Clinical and Demographic Characteristics of Patients with Coexistent Hypertension, Type 2 Diabetes Mellitus, and Dyslipidemia: A Retrospective Study from India. Drugs-Real World Outcomes. 2024;11(1):167-76. DOI: https://doi.org/10.1007/s40801-023-00400-3
Vekic J, Stromsnes K, Mazzalai S, Zeljkovic A, Rizzo M, Gambini J. Oxidative Stress, Atherogenic Dyslipidemia, and Cardiovascular Risk. Biomedicines. 2023;11(11):2897. DOI: https://doi.org/10.3390/biomedicines11112897
Franco C, Sciatti E, Favero G, Bonomini F, Vizzardi E, Rezzani R. Essential Hypertension and Oxidative Stress: Novel Future Perspectives. Int J Mol Sci. 2022;23(22):14489. DOI: https://doi.org/10.3390/ijms232214489
European Society of Cardiology. Available at: https://www.escardio.org/. Accessed on 12 June 2025.
Borghi C, Fogacci F, Agnoletti D, Cicero AFG. Hypertension and Dyslipidemia Combined Therapeutic Approaches. High Blood Press Cardiovasc Prev Off J Ital Soc Hypertens. 2022;29(3):221-30. DOI: https://doi.org/10.1007/s40292-022-00507-8
Abdalsahib Al Zamili AF. The Coexistence of Hypertension and Dyslipidemia in a Cohort of Iraqi patients with essential Hypertension: Cross Sectional Study. Am J Biomed Sci Res. 2019;3(1):15-8. DOI: https://doi.org/10.34297/AJBSR.2019.03.000626
Kostis JB, Breazna A, Deedwania PC, LaRosa JC, Treating to New Targets Steering Committee and Investigators. The benefits of intensive lipid lowering in patients with stable coronary heart disease with normal or high systolic blood pressure: an analysis of the Treating to New Targets (TNT) study. J Clin Hypertens Greenwich Conn. 2008;10(5):367-76. DOI: https://doi.org/10.1111/j.1751-7176.2008.07851.x
Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cífková R, Dominiczak AF, et al. Hypertension. Nat Rev Dis Primer. 2018;4:18014. DOI: https://doi.org/10.1038/nrdp.2018.14
Desai N, Unni G, Agarwala R, Salagre S, Godbole S, Dengra A, et al.
Risk Factors and Comorbidities in Young Indian Patients with Hypertension: REAL YOUNG (Hypertension) Study
. Integr Blood Press Control. 2021;14:31-41. DOI: https://doi.org/10.2147/IBPC.S272548Varghese JS, Venkateshmurthy NS, Sudharsanan N, Jeemon P, Patel SA, Thirumurthy H, et al. Hypertension Diagnosis, Treatment, and Control in India. JAMA Netw Open. 2023;6(10):e2339098. DOI: https://doi.org/10.1001/jamanetworkopen.2023.39098
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):1269-324. DOI: https://doi.org/10.1161/HYP.0000000000000066