Metoprolol: The Preferred Beta-Blocker in Indian Cardiovascular Medicine

Overview of the ROBUST Study

A significant study focusing on knowledge, attitudes, and practices (KAP) among healthcare professionals in India has revealed that metoprolol remains the top choice for beta-blocker therapy throughout the cardiology care continuum. This finding underscores its strong clinical acceptance in modern medical practices. The Real-World Perception Survey, known as ROBUST, was conducted among 1,000 healthcare professionals, including consulting physicians and cardiologists involved in adult cardiovascular care.

Study Details and Publication

ROBUST is among the largest clinician-led surveys assessing beta-blocker usage in Indian cardiovascular settings. The results were published in the February 2026 issue of the Journal of the Association of Physicians of India (JAPI). The study features contributions from notable Indian cardiologists, including Dr. JS Hiremath, Dr. Arup Dasbiswas, Dr. JPS Sawhney, Dr. Subhash Chandra, Dr. PP Mohanan, and Dr. Swati Srivastava.

Methodology

The survey was designed as a cross-sectional, questionnaire-based study conducted nationwide. Out of 1,000 distributed questionnaires, 855 were completed, yielding a response rate of 85.5%. The respondent group comprised consulting physicians (50.4%), cardiologists (40%), and other specialists engaged in adult cardiovascular care. Responses were collected from all geographical regions of India, including the West (34.6%), East (27.4%), South (25%), and North, ensuring wide national representation.

Questionnaire Design and Findings

The ROBUST study utilized a comprehensive 26-item structured questionnaire that addressed beta-blocker usage across various cardiovascular conditions, including hypertension, heart failure, post-myocardial infarction care, chronic coronary syndromes, and atrial fibrillation. The questionnaire was developed through a thorough literature review and expert consultations, aiming to capture clinicians’ knowledge, attitudes, and prescribing practices regarding beta-blockers in everyday care.

A notable finding from the survey is metoprolol’s consistent preference across multiple cardiovascular indications: it was the choice for 75% of hypertension cases, 66% for heart failure, 78% for post-myocardial infarction management, 83% for chronic coronary syndrome, and 85% for atrial fibrillation. This assessment represents one of the first thorough evaluations of beta-blocker prescribing patterns in India in recent years, offering updated evidence on clinical preferences that align with evolving practice guidelines.

Significance of the Findings

The survey reflects the perspectives of various specialties and levels of care, providing valuable insights into the role of beta-blockers in routine cardiovascular treatment across diverse clinical settings in India. Conducted within a contemporary clinical framework, the survey sheds light on current beta-blocker usage at a time when cardiovascular treatment algorithms and guidelines are continually being refined.

These findings are particularly pertinent in the Indian context, where cardiovascular diseases frequently manifest earlier and with greater complexity, affecting long-term management and therapeutic decisions.

Accessing the Full Study

For those interested in the complete study findings, the full publication is available in JAPI at the following reference: 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. Accessible at: https://japi.org/article/japi-74-2-e1