CLINICAL DECISION-MAKING CRITERIA FOR SWITCHING OR COMBINING ANTIHYPERTENSIVE MEDICATIONS: A PHYSICIAN-BASED SURVEY

Background: Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality. Despite the availability of various classes of antihypertensive drugs, optimal blood pressure control remains elusive in many patients, necessitating decisions about switching or combining therapies. Objective: This study aims to assess the criteria physicians use to switch or combine antihypertensive medications in routine clinical practice. Methods: A cross-sectional, questionnaire-based survey was conducted among 250 practicing physicians across tertiary and secondary healthcare centers in Eastern India. The questionnaire explored clinical, patient-related, and drug-related factors influencing treatment modification. Results: Poor blood pressure control (92%), adverse drug reactions (68%), patient non-adherence (55%), and comorbidities (46%) emerged as major criteria for switching drugs. Drug combinations were preferred when monotherapy failed, especially in patients with Stage 2 hypertension (78%) or high cardiovascular risk (65%). Conclusion: The study highlights prevalent decision-making patterns and reinforces the need for clear guidelines to optimize antihypertensive therapy adjustments in diverse clinical contexts.