Blood Pressure Screening Research Articles

May Measurement Month 2019: an analysis of blood pressure screening results from Taiwan.

To bolster the awareness of high blood pressure (BP) and to monitor the trend of hypertension control rate. Similar to May Measurement Month (MMM) 2017 and 2018 campaigns, we conducted the MMM 2019 campaign in 643 community pharmacies across Taiwan, and recruited adults aged 20 years or over in May and June of 2019. After filling in an anonymous questionnaire regarding medical history and lifestyle habits and having 10-min sitting rest, pharmacists took triplicate upper-arm BP readings on participants using an automated oscillometric sphygmomanometer. The means of the second and third BP readings were used as the screening BP estimates. Hypertension was defined if one of the followings was met: use of antihypertensive medications, systolic BP ≥140 mmHg, or diastolic BP ≥90 mmHg. Controlled BP was defined as BP of <140/90 mmHg. Of the 24 851 participants enrolled (mean age, 55.8 ± 15.2 years), 12 427 (50.0%) were women. Among 12 351 (49.7%) participants with hypertension, 10 463 (84.7%) were aware of their high BP, and 10 142 (82.1%) received antihypertensive medications. While 59.2% of all hypertensive participants had controlled BP, the BP control rate was 72.0% in treated hypertensive participants. MMM campaigns offer a feasible way to monitor the trends in both awareness and control of hypertension. This nationwide annual BP screening campaign, from 2017 to 2019, demonstrated continued improvement in hypertension control in Taiwan.

May Measurement Month 2019: results of blood pressure screening from 47 countries.

May Measurement Month 2019: results of blood pressure screening from 47 countries.

May Measurement Month 2019: an analysis of blood pressure screening results from Albania.

This article discusses the results of the May Measurement Month (MMM) 2019 campaign, which contributed to a third round of MMM hypertension screening campaigns carried out in Albania, a transitional country in the Western Balkans. The hypertension screening campaign in Albania was carried out during the period 1–31 May 2019 in 30 sites in many districts of the country. Overall, 19 154 participants aged ≥18 years were included (approximately 68% of these were women), with an overall mean age of 47.0 ± 15.3 years. Blood pressure (BP) was measured with OMRON sphygmomanometers (Omron Healthcare, Kyoto, Japan). Hypertension was defined as systolic BP ≥140 mmHg, or diastolic BP ≥90 mmHg, or on treatment for hypertension. Self-reported data consisted of height and weight, pre-existing conditions, including smoking status and alcohol consumption. Overall, the proportion of participants with hypertension was 38.6%. Less than two-thirds (64.7%) of hypertensive individuals were aware of their condition. Also, less than half (48.3%) of participants on antihypertensive medication had controlled BP (<140/90 mmHg). The most sizable correlations of high BP were with known hypertension status, use of antihypertensive medication, and obesity. The MMM campaign contributes to routine hypertension screening in Albania. Hence, health professionals and policymakers in Albania should act on the findings of MMM screening campaigns and continue its support as a valuable tool for early detection of hypertension in the general population.

May Measurement Month 2019: an analysis of blood pressure screening results from Malaysia.

Despite hypertension remaining the leading cause of death worldwide, awareness of hypertension and its control rate is still suboptimal in Malaysia. This study aims to determine the proportion of both diagnosed and undiagnosed hypertension, awareness and its control rate during the yearly May Measurement Month (MMM) campaign that has been coordinated by the International Society of Hypertension. Participants aged ≥18 years were recruited at various screening sites namely universities, health facilities, shopping malls, and other sites. Participant’s socio-demographic, environmental, and lifestyle data were captured using a questionnaire. Three blood pressure (BP) readings as well as anthropometric measurements were obtained from all participants. The mean of the second and third BP readings was used in analyses. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medication. A total of 3062 participants were recruited. The proportion with hypertension in our study was 18.7% (n = 572). The proportion who were aware of their BP status was 63.2%. More than half (57.2%) of the hypertensives were on antihypertensive medication and 70.3% of those treated were controlled. In conclusion, in this BP screening campaign, one in five were hypertensive with almost two thirds aware of their hypertensive status. BP control among those who are taking medications was high at 70% but under 60% of hypertensives were on treatment. Hypertension screening programmes are important to promote awareness and control of hypertension as well as to reduce the devastating complications associated with this disorder.

May Measurement Month 2019: an analysis of blood pressure screening results from Lebanon.

Hypertension is an important public health concern of high prevalence among adults. It is associated with an increased mortality rate. The prevalence of hypertension in Lebanon has increased during the last decades, affecting around one-third of the Lebanese population. Since diagnosis and treatment of hypertension is associated with a better prognosis, annual screening and raising awareness about this ‘silent killer’ disease is of extreme value. We conducted a cross-sectional survey in various Lebanese cities in 2019. We recruited adults (≥18 years old) from different sites, through an opportunistic sampling method. For each participant, three blood pressure (BP) readings were recorded and the average of the last two was analysed. In addition, data on lifestyle factors and comorbidities were collected. Participants were considered hypertensive if they had at least one of the following: systolic or diastolic BP ≥140 and/or ≥90 mmHg, respectively, or taking antihypertensive medication. Blood pressure was measured in 7019 participants. The mean age was 46.0 (SD 16.6) years. In total, 2572 participants (36.6%) had hypertension among whom only 64.1% were aware of their disease and 62.3% were on treatment. Blood pressure was controlled in 62.6% of participants taking antihypertensive medications. This study is the largest on hypertension prevalence in Lebanon. The results demonstrated that around one-third of the hypertensive population were not aware of their disease, and that a high percentage was not being treated. These results suggest the need for rapid interventions aimed at raising awareness regarding hypertension in the Lebanese population.

May Measurement Month 2019: an analysis of blood pressure screening results from Cape Verde.

The Cabo Verdean population is aging and, consequently, non-communicable diseases, namely cardiovascular diseases, are increasing, with hypertension being an important risk factor. Following Cabo Verde's engagement with the May Measurement Month (MMM) campaign, in 2019, it was possible to improve the screening capacity, at the same time that a major social mobilization campaign was carried out to improve the population's knowledge about raised blood pressure (BP) and its consequences. With activities on nine islands, telemedicine was used to train researchers and volunteers. The MMM app was used to collect participant data. Individuals aged ≥18 years were recruited through opportunistic sampling. Each participant completed a questionnaire on demographic, lifestyle and environmental factors and had three BP measurements and weight and height measurements. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg (mean of the second and third readings), or when using antihypertensive medication. When respondents did not provide three BP readings, multiple imputation using chained equations was used to calculate the mean of the second and third readings. A total of 17 627 individuals [mean age of 42.7 (SD 16.2); 63.8% women] were screened. After multiple imputation, 5990 (34.0%) had hypertension, of which 68.4% knew the diagnosis previously and 51.3% used antihypertensive drugs. The reported use of antihypertensive medication and a previous diagnosis of hypertension were strong predictors of higher levels of systolic and diastolic BP. Corrective actions were taken with an updated national protocol for hypertension treatment in primary health care. The II Non-Communicable Diseases Survey corroborated MMM national data that we see as an ideal initiative to reach the public, raising awareness about this important cardiovascular risk factor and providing political decision instruments.

May Measurement Month 2019: an analysis of blood pressure screening results from Zambia.

In Zambia, hypertension accounts for the highest proportion of deaths due to cardiovascular diseases causing 3.3% of all deaths, killing an average of 670 people per year. May Measurement Month (MMM) is an annual global screening campaign aiming to improve awareness of blood pressure (BP) at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at multiple sites within Lusaka during May and June 2019. Ideally, three BP readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Data were analysed centrally by the MMM project team and multiple imputations were performed where necessary. Of the total of 9232 enrolled, 8.7% of them had never had their BP measured, 2.5% had diabetes mellitus, 1.9% had had a myocardial infarction, 1.5% had had a stroke, 10.6% were current smokers, and 10.0% consumed alcohol once or more per week. Blood pressure fell from a mean of 128.6/82.9 mmHg for the 1st reading to a mean of 123.2/80.0 mmHg for the 3rd reading. The lowest proportion of participants with hypertension was identified by the 3rd reading alone (30.0%). Of all the participants, 30.7% had hypertension, though only 42.6% of them were aware of their diagnosis. Seven hundred and eighty-three (27.6%) were on antihypertensive medication though only 35.0% of them had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). Compared with MMM17 data, there is deterioration of the monitored parameters calling for urgent and accelerated public health policy and clinical practice interventions. We think that the MMM campaign should continue annually to raise awareness of this treatable condition.

May Measurement Month 2019: an analysis of blood pressure screening results from Republic of the Congo.

The aim of this study was to determine the proportion with hypertension among an opportunistic sample of the population of the Republic of the Congo. Screening was conducted during the period from 15 May to 15 June 2019. Participants included, consenting persons 18 years of age and over, from five cities: Brazzaville, Pointe-Noire, Oyo, Owando, and Ouesso. In total, 3157 participants were screened as part of the campaign. The mean age was 44.7 years (SD: ±14.9), and 47% were male. Based on the total participants, 881 (27.9%) were overweight and 447 (14.2%) were obese. A total of 583 (18.5%) participated in MMM 2017 or 2018 screenings. The proportion with hypertension was 33.5% (n = 1057), 42.6% of those were aware and 37.3% were taking antihypertensive medication. Of the participants on treatment, 62.4% were controlled (<140/90 mmHg). Overall, 23.3% of patients with hypertension were controlled. After imputation, the proportions with hypertension were 30.1% (n = 1475) according to standardized age and sex. Obesity (P < 0.001) and alcohol intake (P < 0.001) were associated with higher BP compared with normal weight and non-drinkers, respectively. With regards to the social disparities of the different regions of Congo, large scale screening is necessary, in order to report the real situation of hypertension. This will improve the overall management policy for this condition in our country.

May Measurement Month 2019: an analysis of blood pressure screening results from Ecuador.

Arterial hypertension is a growing burden worldwide, leading to over 10.8 million deaths each year. In Ecuador, it is the main risk factor for the major cause of death, coronary, and cerebrovascular disease [GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1923–1994]. The May Measurement Month Campaign in 2019 (MMM19) is a global initiative of the International Society of Hypertension aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of screening programs worldwide. A volunteer cross-sectional survey was carried out in May 2019 across 42 health centres in Ecuador. The average age was 51 (SD ±17.6) years. Blood pressure measurement, the definition of hypertension (mean of the second and third BP measurement ≥140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 15 885 volunteers participated in MMM19. After multiple imputation, 6654 (41.9%) had hypertension. Of individuals not receiving antihypertensive medication, 2383 (20.5%) were hypertensive. Of individuals receiving antihypertensive medication, 1004 (23.5%) had uncontrolled BP. May Measurement Month 2019 was the largest BP screening campaign done in Ecuador. In the survey, including 6654 participants with hypertension, only 49.1% had their BP values controlled (<140/90 mmHg). May Measurement Month 2019 demonstrated a high prevalence of hypertension among volunteer screenees in our country. The high percentage of persons untreated or with uncontrolled hypertension while on pharmacologic treatment suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of health care providers and the healthcare system in Ecuador.

Prevalence of Use of Preventive Services in Poland: Result from a Population-Based Nationwide Study.

Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. This study aimed to assess the prevalence of all recommended evidence-based preventive services in a publicly funded healthcare setting. We conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults (response rate 42%). The self-reported use of all recommended clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. The results showed that only 6.4% of adults had received all recommended preventive screening, whereas only 4.3% had received appropriate counselling. General practitioner (GP) visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, while flu vaccination, PSA assessment, and preventive counselling were among the least prevalent services. Despite the low uptake of preventive interventions, over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations. Our findings suggest that there are significant gaps in the receipt of preventive interventions. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process.

Reaching underserved South Africans with integrated chronic disease screening and mobile HIV counselling and testing: A retrospective, longitudinal study conducted in Cape Town.

Community-based, mobile HIV counselling and testing (HCT) and screening for non-communicable diseases (NCDs) may improve early diagnosis and referral for care in underserved populations. We evaluated HCT/NCD data and described population characteristics of those visiting a mobile clinic in high HIV disease burden settings in Cape Town, South Africa, between 2008 and 2016. Trained counsellors registered patients ≥12 years old at a mobile clinic, which offered HCT and blood pressure, diabetes (glucose testing) and obesity (body mass index) screening. A nurse referred patients who required HIV treatment or NCD care. Using multivariable logistic regression, we estimated correlates of new HIV diagnoses adjusting for gender, age and year. Overall, 43,938 individuals (50% male; 29% <25 years; median age = 31 years) tested for HIV at the mobile clinic, where 27% of patients (66% of males, 34% of females) reported being debut HIV testers. Males not previously tested for HIV had higher rates of HIV positivity (11%) than females (7%). Over half (55%, n = 1,343) of those previously diagnosed HIV-positive had not initiated ART. More than one-quarter (26%) of patients screened positive for hypertension (males 28%, females 24%, p<0.001). Females were more likely overweight (25% vs 20%) or obese (43% vs 9%) and presented with more diabetes symptoms than males (8% vs 4%). Females (3%) reported more symptoms of STIs than males (1%). Reporting symptoms of sexually transmitted infections (aOR = 3.45, 95% CI = 2.84, 4.20), diabetes symptoms (aOR = 1.61, 95% 1.35, 1.92), and TB symptoms (aOR = 4.40, 95% CI = 3.85, 5.01) were associated with higher odds of a new HIV diagnosis after adjusting for covariates. Findings demonstrate that mobile clinics providing integrated HCT and NCD screening may offer the opportunity of early diagnosis and referral for care for those who delay screening, including men living with HIV not previously tested.

Reduction in Monocyte Isolevuglandins Associated with High Interstitial Sodium Mirrors Salt‐Sensitivity of Blood Pressure in Patients with Essential Hypertension

Salt Sensitivity (SS) of blood pressure (BP) is an independent risk factor for cardiovascular mortality. Sodium (Na+) is stored in skin and muscle interstitium. Antigen presenting cells are activated in response to elevated extracellular Na+ in an ENaC-dependent manner resulting in formation of (isolevuglandin) IsoLG-protein adducts. This leads to T-cell activation, release of inflammatory cytokines, kidney damage, endothelial dysfunction and an increase in BP. We aimed to determine the effect of tissue Na+ storage and immune cell activation on salt-sensitive hypertension. Five subjects with essential hypertension discontinued all anti-hypertensive therapy two weeks before the study. SS was assessed by a rapid inpatient protocol of salt loading (460 mmoL/24 hours) and salt depletion (10 mmoL/24 hours, plus furosemide 40 mg x 3). 23Sodium magnetic resonance imaging was used to measure muscle and skin Na+ contents at baseline (BA). Urine and serum electrolytes, glomerular filtration rate, plasma renin, aldosterone levels, plasma and urine EETs (8-9, 11-12 and 14-15 isoforms) and the percentage of IsoLG adduct-containing CD14+ monocytes via flow cytometry were measured at BA, after salt-loading (HI) and after salt-depletion (LO). All continuous data are displayed as median (interquartile range). Spearman's correlation was used to test associations. 60% of subjects were female, median age was 54 years (44-55), BMI was 35 kg/m2 (30-39), and screening BP was 140/88 mmHg (134-148 / 84-99). The range of the drop in systolic BP from HI to LO (salt-sensitivity index, SSI) was -13.8 to +1.8 mmHg. %isoLG+ CD14+ cells were 48 (27-65) at BA, 55 (31-56) at HI, and 70 (33-72) at LO (p=0.594, by the Kruskal-Wallis test). The correlation between SSI and delta (∆) %isoLGLO minus HI in CD14+ monocytes, was 0.86, [95% confidence interval (CI), -0.07-0.99] (Figure 1A). Skin Na+ content correlated with baseline % IsoLG+ CD14 (r=0.91; 95% CI, 0.12-0.99) (Figure 1B). Higher excretion of urine EETs associated with less IsoLG+ CD14+ cells whereas higher plasma aldosterone per unit urine EET, (a marker of net stimulation of ENaC) associated with a greater number of IsoLG-containing CD14+ cells. No such relationships were observed with plasma EETs. Finally, less stimulation of the aldosterone/urine EET ratio by salt depletion associated with a greater fall in IsoLG+ CD14+ cells (Figure 1C). The change in IsoLG-containing CD14+ monocytes in response to salt depletion appears to be associated with SSBP, which if confirmed in larger number of subjects could constitute a biomarker for SSBP in humans. The association between baseline % of IsoLG-containing CD14+ monocytes and skin Na+ suggests that activation of these cells is due to hyperosmolar Na+ exposure in some interstitial compartment of the body. Relationships between IsoLGs and urine but not plasma EETs suggest that this exposure could be occurring in the hyperosmolar renal medulla.

Effects of MitoQ on Central Hemodynamics, Arterial Stiffness, and Oxidative Stress In Healthy, Young Adults

PURPOSE Cardiovascular disease is characterized by blood pressure (BP) dysregulation and vascular dysfunction, secondary to vascular oxidative stress. Exogenous antioxidants mitigate vascular oxidative stress by scavenging reactive oxygen species (ROS). MitoQ, a mitochondrial specific antioxidant improves vascular function and reduces elevated arterial stiffness in older adults. However, it is unclear if MitoQ improves vascular function in healthy young adults for primary prevention purposes. Therefore, central hemodynamics, arterial stiffness, and measures of oxidative stress were assessed in healthy young adults before and after acute MitoQ (or placebo) supplementation. METHODS Eleven participants (six females, age: 26±4 years, BMI: 25±3 kg/m2, screening BP: 109±10/65±4 mmHg, Mean±SD) reported to our laboratory for two separate sessions (crossover design) and randomly assigned either a placebo or MitoQ protocol (100-160mg, depending on body mass). Sessions were separated by ≥72-hour wash out period. Laboratory measures were performed before and 45 minutes after MitoQ (or placebo) capsules were ingested. Following ≥10 minutes of quiet rest, triplicate readings of brachial (oscillometric) and aortic BP (SphygmoCor) were obtained. We assessed carotid-femoral pulse wave velocity (PWV) and augmentation index as indices of arterial stiffness. We obtained blood samples via intravenous catheter placement to assess ROS levels with electron paramagnetic resonance and plasma superoxide dismutase activity using an enzymatic assay kit. 2-way ANOVAs were performed to determine effects on treatment x time interaction. RESULTS No significant treatment x time interactions for brachial (p=0.52) and aortic (p=0.64) systolic BP readings, or brachial (p=0.34) and aortic (p=0.11) diastolic BP readings were observed. However, brachial systolic BP tended to modestly increase after capsule ingestion (placebo:114±8 to 118±9; MitoQ: 116±11 to 118±8; time: p=0.05). Carotid-femoral PWV did not change following placebo (4.3±0.7 to 4.5±0.8 m/s) or MitoQ (4.3±0.7 to 4.4±0.8 m/s) ingestion (time: p=0.35, interaction p=0.30). Augmentation index decreased from pre- to post- capsule ingestion for both placebo (14±9 to 11±8 %) and MitoQ (14±9 to 10±8 %; time: p<0.01) with no significant interaction (p=0.28). There was no significant treatment x time interaction for Blood ROS (p=0.99) concentration or plasma superoxide dismutase activity (p=0.89). CONCLUSIONS While additional data are needed to build our sample size and determine if there are racial or ethnic differences in responses, our preliminary findings suggest that acute MitoQ supplementation does not influence central hemodynamics or arterial stiffness in healthy, young adults.

Letter to the Editor Regarding “Hypertension Awareness, Treatment, and Control in Mexico: An Opportunistic Medical Student-led Blood Pressure Screening Campaign – A Cross-Sectional Study”

Letter to the Editor Regarding “Hypertension Awareness, Treatment, and Control in Mexico: An Opportunistic Medical Student-led Blood Pressure Screening Campaign – A Cross-Sectional Study”

Response to Letter to the Editor Regarding “Hypertension Awareness, Treatment, and Control in Mexico: An Opportunistic Medical Student-led Blood Pressure Screening Campaign – A Cross-Sectional Study”

Response to Letter to the Editor Regarding “Hypertension Awareness, Treatment, and Control in Mexico: An Opportunistic Medical Student-led Blood Pressure Screening Campaign – A Cross-Sectional Study”

Young@Heart clinic: a feasibility study of an undergraduate pharmacy student-led blood pressure and healthy lifestyle clinic.

Student-led clinics offer a work-based learning (WBL) opportunity for undergraduate healthcare students to engage with professional activities in a real-life setting. Participation is posited to provide experiential learning and prepare students for clinical practice. This study aims to assess the feasibility of establishing and engaging undergraduate students in one such initiative through the collaboration between one School of Pharmacy and local authority. The clinic was developed using a logic model and delivered in 2019-2020. A service specification and training were developed and provided to volunteering undergraduate pharmacy students. Anonymised service data were collected and process outcomes around student and public engagement were recorded to assess feasibility for longer-term embedding into the undergraduate programme. The clinic was operational for 20 days from November 2019 to February 2020. Student volunteers (n = 43, 36.7%) were trained and provided blood pressure screening and healthy living advice to 131 members of the public. Student drop-out occurred due to the voluntary nature of the initiative. Collaborative working with the local authority facilitated this WBL experience outside conventional clinical environments. The study demonstrated the potential for students to participate in service provision. This offers value to the local population through a health prevention service when a structured approach to the design and delivery of the educational experience is undertaken. The study provides insight into how the WBL can work, what it requires (e.g. resource, preparation), and learning to inform the wider implementation of this WBL into the undergraduate curriculum.

Sustained high blood pressure and 24-h ambulatory blood pressure monitoring in Tanzanian adolescents

Estimates for prevalence of high blood pressure (BP) among adolescents in Africa vary widely and few studies, if any, have documented the results of the recommended stepwise BP screening. In this cross-sectional study in Tanzania, we aimed to estimate prevalence of sustained high BP in 3 public secondary schools using the American Academy of Pediatrics BP screening strategy. On Day 1, one screening automated office BP (AOBP) measurement (Step 1) was followed by two more AOBP measurements (Step 2). Repeat AOBP measurements were obtained after about one month on adolescents with high AOBP measurements on Day 1 (Step 3). Participants with sustained high BP underwent 24-h ambulatory BP monitoring (step 4). Of all 500 enrolled participants, the prevalence of high blood pressure at each step in the process was 36.6% (183), 25.6% (128), 10.2% (51), and 2.6%(13) respectively for Steps 1–4. All except 6 students completed all 4 steps of the BP screening algorithm as indicated. We conclude that diagnosis of hypertension in African adolescents should use multiple AOBP measurements over multiple days followed by 24-h ABPM. Screening for high BP in school settings appears to be feasible and could provide a platform for cardiovascular disease education and health promotion.

SURVEY OF AWARENESS AND ATTITUDES TO CLINICAL RESEARCH AND CARDIOVASCULAR HEALTH AMONG ETHNIC MINORITIES IN GLASGOW

Objective: Despite efforts to increase diversity in clinical trials, racial/ethnic minority groups generally remain underrepresented, limiting researchers’ ability to test the efficacy and safety of new interventions across diverse populations. Previous research identified minority patient barriers to participation in clinical trials such as mistrust in medical researchers, fear of experimentation, and other logistical issues (language, transportation and financial barriers). Our aim is to design an observational survey to help understand the barriers or enablers that affect our local ethnic minority population in Glasgow when it comes to their own health and involvement in clinical research. Design and method: Surveys were conducted at two events in Glasgow – one South Asian (SA) and the other African (AF) where blood pressure screening was offered along with cardiovascular health advice. Participants completed a survey designed to examine awareness of cardiovascular health and attitudes to health and clinical research. Chi-square test was used to examine the association between races. Results: 65 SA and 31 AF individuals completed the survey. There were significant differences between the demographics of the groups. The AF participants were younger with 87% between 25 and 54 years of age, while the SA participants were represented across all age groups. The questions which showed significant differences between groups are as follows: “Do you think that the current treatment guidelines for cardiovascular diseases are tailored for different ethnicities?”(Yes-SA: 32%; AF: 16%); “Do you believe treatment of conditions for your ethnic group is likely to be different compared to other ethnic groups?”(Yes-SA: 39%, Yes-AF: 52%); “Friends/family as source of health information” (No-SA: 88%, No-AF: 68%); “I do not know anything about clinical trials – I am not interested in knowing more” (No-SA: 66%, No - AF: 84%); I know what clinical trials are and I am keen to participate (No-SA: 88%, No-AF: 65%); Willingness to take part in clinical trials in the future (Yes -SA: 49%, Yes-AF: 74%); Trials will advance science and help treatment of their condition (No-SA: 83%, No-AF: 61%) Conclusions: There are differences in understanding and attitudes to clinical research between the SA and AF individuals. A tailored approach is necessary to overcome the lack of understanding of both health and clinical research in these two groups.

THE VALUE OF EMERGENCY DEPARTMENT BLOOD PRESSURE MEASUREMENT FOR THE SCREENING OF HYPERTENSION. PAIN IS A SIGNIFICANT FACTOR? SEEMS NOT

Objective: The value of emergency department (ED) blood pressure measurement for the screening of hypertension remains unclear. A systematic review was conducted to assess the performance of a screening strategy in adults using blood pressure (BP) measurement at the time of an ED consultation. The link between pain and high blood pressure is also described. Design and method: A systematic literature search on Embase, CINHAL and Medline was carried out. This systematic review was conducted in accordance with the PRISMA-Diagnostic Test Accuracy. Intervention studies with adults including at least one BP measurement for all participants were included. A repeat blood pressure assessment had to have been carried out to assess the validity of the elevated BP value within the next few days after the ED initial visit. Results: After review of 1,030 articles published between 1985 and 2018, 10 articles met the inclusion criteria. Mean age of participants was 51.6 years. A single study reports that BP screening was measured according to all the recommendations within the HTN guidelines referred to in the study. Half of the patients (50.2%) with elevated BP during the ED visit had BP corresponding to uncontrolled elevated blood pressure at follow-up measurement. Data about pain and blood pressure is reported in six of the included studies. None of these found a significant relationship between the concomitant presence of pain and an elevated BP measurement, and the fact of having an elevated or normal BP in a subsequent measurement without the presence of pain. Conclusions: The value of the blood pressure measurement in the ED is far from useless because it allows recognizing a true hypertension in one in two adults presenting with elevated BP. Moreover, it would be a mistake to attribute to pain alone the fact of presenting with an elevated OBPM in ED. Such patients could just as well be hypertensive when an ambulatory measurement is performed later without the presence of pain.

PREVALENCE AND ASSOCIATED FACTORS OF HYPERTENSION AMONG RETIRED INDIAN ARMY IN POKHARA METROPOLITAN

Objective: To assess the prevalence and associated factors with hypertension among the retired Indian army living in a semi-urban area of Pokhara metropolitan. Design and method: The cross-sectional study was conducted among retired Indian army living in a semi-urban area of Pokhara metropolitan. Data on blood pressure (BP), anthropometric measurements, smoking, alcohol intake, physical activity, obesity and dietary factors were collected by face-to-face interview using WHO STEPwise approach to non-communicable disease risk factor surveillance (STEPS) questionnaire translated in Nepali language. Results: Among the 317 retired Indian army interviewed, the prevalence of hypertension was 68.1%. Mean blood pressure systolic was 144.48 mmHg, and diastolic was 89.3 mmHg. Prevalence of smoking any tobacco products was 12.9%, and consumption of alcohol products was 86.1%. One fourth (25.9%) of the respondents had a family history of hypertension. Over one half (51.4%) were classified as overweight (BMI), and 6.6% had central obesity. Respondents with age group (55–64) years were found more than three times (OR: 3.21, 95% CI: 1.91–8.68) likely to have hypertension. Alcohol consumers were 1.8 times more likely to have hypertension than non-consumers. Respondents with a family history of hypertension were found 2.57 folds to have hypertension. Conclusions: Hypertension among retired Indian army is comparatively much higher than the general population in the study area. The finding of the study calls for an immediate primary care to the high-risk occupation groups targeting prevention, screening and control measures for blood pressure and associated risk factors.