Hypertension in the Context of Comorbidities: Understanding Patient Profiles for Precision Management

Abstract

Hypertension (HTN) is a leading contributor to cardiovascular morbidity and mortality, yet its management is often complicated by coexisting conditions. This narrative review addresses the challenge of HTN in a complex clinical landscape by proposing a new framework of clinically intuitive patient profiles based on specific comorbidities. We define profiles such as hypertension with diabetes ("Diatension"), obesity ("Obetension"), chronic kidney disease ("Nephrotension"), and heart failure ("Myotension") to re-envision HTN management beyond simple blood pressure thresholds. Each profile is explored with a focus on its epidemiology in India, shared pathophysiological mechanisms, and unique therapeutic priorities. An overview has been introduced to show the anti-hypertensive choices according to comorbidity type.  We highlight how these clinically relevant profiles, rooted in established evidence, can enhance risk stratification and communication. The review suggests that moving from a "hypertension-alone" approach to a patient profile-driven strategy, particularly in regions like India where cardiometabolic clustering is prominent, has the potential to guide more precise and patient-centered care. The proposed paper aims to streamline multidisciplinary dialogue, improve patient understanding, and provide a roadmap for more integrated and effective treatment strategies. This approach encourages a shift toward precision management that considers the entire disease constellation rather than isolated numerical targets.