One of the largest Indian KAP studies including doctors in cardiovascular medicine practice has shown that metoprolol continues to be the most preferred beta-blocker across the cardiology care continuum, reinforcing its clinical acceptance in contemporary practice.
A Real-World Perception Survey (ROBUST) is a nationwide knowledge, attitude, and practice (KAP) survey conducted among 1,000 Indian healthcare professionals (HCPs), including consulting physicians, cardiologists, and other specialists involved in adult cardiovascular care. The study is among the largest clinician-led KAP surveys evaluating beta-blocker use in Indian cardiovascular practice, and its results have been published in the latest February 2026 issue of the Journal of the Association of Physicians of India (JAPI).
The study is authored by eminent Indian cardiologists including Dr. JS Hiremath, Dr. Arup Dasbiswas, Dr. JPS Sawhney, Dr. Subhash Chandra, Dr. PP Mohanan, and Dr. Swati Srivastava, ROBUST uniquely probes beta-blocker prescribing across four major CV indications through an item questionnaire designed to decode real-world clinical decision-making patterns.
The ROBUST study was designed as a cross-sectional, questionnaire-based survey conducted pan-India. A total of 1,000 questionnaires were distributed to doctors across India, of which 855 completed responses were received and analysed, translating into a high response rate of 85.5%. The respondent pool included consulting physicians (50.4%), cardiologists (40%), and other specialists involved in adult cardiovascular care. Responses were received from all regions of the country, including the West (34.6%), East (27.4%), South (25%), and North, reflecting broad national participation.
The study employed a detailed 26-item structured questionnaire designed to span the entire cardiovascular care continuum, covering beta-blocker use across hypertension, heart failure, post-myocardial infarction care, chronic coronary syndromes, and atrial fibrillation. The questionnaire was developed through literature review and expert consultation to capture clinicians' knowledge, attitudes, and routine prescribing practices related to beta-blocker use in everyday cardiovascular care.
A key finding was metoprolol's consistent dominance across all cardiovascular indications – from hypertension (75%) and heart failure (66%) to post-MI management (78%), chronic coronary syndrome (83%), and atrial fibrillation (85%). This represents one of the first comprehensive assessments of beta-blocker prescribing patterns in India in recent years, providing updated real-world evidence on clinical preferences that have evolved with contemporary practice guidelines.
The survey captures perspectives across specialties and levels of care, providing insight into the place of beta-blockers within routine cardiovascular practice across diverse Indian clinical care settings.
Conducted in a contemporary clinical setting, the survey provides current insights into beta-blocker use at a time when cardiovascular treatment algorithms and guideline interpretations continue to evolve. The findings are particularly relevant in the Indian context, where cardiovascular disease often presents earlier in life and with greater clinical complexity, influencing long-term disease management and therapeutic decision-making.
To read the complete study findings, access the full publication in JAPI at: Hiremath J,Dasbiswas A, Sawhney J, et al. Role of β-Blockers Across the Cardiovascular Continuum: A Real-World Perception Survey (ROBUST). J Assoc Physicians India 2026;74(2):e1–e7. https://japi.org/article/japi-74-2-e1
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