UNDERSTANDING THE REALITY OF HIGH BLOOD PRESSURE SCREENING AND MONITORING IN THE RURAL POPULATION FROM THE CROATIAN RURAL AREA DAMAGED BY AN EARTHQUAKE: “THE SILENT KILLER HUNT”

Abstract

Objective: Arterial hypertension (AH) is the most important independent risk factor for cardiovascular diseases. Unfortunately, less than half of adults with hypertension are diagnosed and treated. It is well known that home blood pressure (BP) monitoring is a useful method for follow-up and for detecting patients with asymptomatic hypertension. Home BP monitoring is inexpensive and well-accepted by patients, which are both great benefits for the screening method. The prevalence of AH in Croatia differs by region, in addition, residents of rural areas have poorer access to healthcare. The aim of this study was to find the prevalence of AH in subjects who did not report a medical history of AH and to find the prevalence of subjects who own home BP monitors in rural areas. Design and method: A total of 214 participants (opportunistic screening) were asked about previous AH diagnoses and whether they own a home BP monitor in our cross-sectional survey. BP was measured following ESH guidelines using Microlofe oscillometric device. AH stage 1 was considered if systolic BP was 130 mmHg or higher, or diastolic 80 mmHg or higher. Results: Out of a total of 214 respondents, 120 respondents (56%) reported that they had AH. In a group who answered that either they didn’t have or didn’t know if they had AH, high BP was measured in 61.96%. Interestingly, only 46 (21.5%) reported that they do not have a home BP monitor, and 168 participants (78.5 %) confirmed having a BP monitor at home. Conclusions: Our results revealed poor awareness of AH and showed the utility of the AH screening intervention, particularly in rural areas. More research is needed to determine the best screening methods and further applications for the general population. Our findings may also help healthcare workers to understand the potential of home BP monitoring for their patients because a large number of survey respondents even in rural areas own a BP monitor. This discovery can enhance the quality of patient education, patient-physician relationship, and follow-up practice for successful BP monitoring.