The Association of Physicians of India (API) in collaboration with the Indian College of Physicians (ICP) have released guidelines on the management of hypertension in Indian patients with Type 2 Diabetes Mellitus (T2DM). 

Given the high cardiovascular risk in T2DM, the guideline recommends a treatment of dual antihypertensive therapy, specifically combining Angiotensin Receptor Blockers (ARBs) with Calcium Channel Blockers (CCBs) for their effectiveness in reducing BP and safeguarding against cardiovascular complications

A notable inclusion in the 2024 guidelines is the recommendation of newer CCBs, with a specific focus on Cilnidipine. Introduced in India in 2007, Cilnidipine has shown promise in offering multiple benefits, not just in reducing BP, but also in protecting crucial organs, especially the kidneys. The guidelines suggest combining Cilnidipine with ARBs to maximize these benefits, while also considering patient-specific factors and comorbidities.

Additionally, Renin-angiotensin system (RAS) blockers should be integral to the treatment regimen, given their proven efficacy in randomized controlled trials (RCTs) for preventing and slowing the progression of diabetic kidney complications. It also recommends use of newer anti-diabetic agents like SGLT2 inhibitors and GLP-1 receptor to improve glycemic control as well as confer macro & micro- vascular protection.

The API-ICP also recommends conditions where the patients should be further referred to specialists for better management of the disease.

One of the key features of the new guidelines is the emphasis on using multiple methods to detect and measure hypertension, including home blood pressure (BP) monitoring. 

In addition, the guidelines advocate for the integration of lifestyle modifications to enhance treatment outcomes. For the first time, the ancient Indian practice of yoga is recommended as an adjunct therapy for managing hypertension in T2DM. Doctors are advised to recommend Yoga's holistic benefits to patients for overall health outcomes.

The guidelines are now available for reference in the Journal of Association of Physicians of India (JAPI).