Hypertension Awareness Research Articles

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis

ObjectiveWe evaluated the effectiveness of team-based care interventions in improving blood pressure (BP) outcomes among adults with hypertension in Africa.DesignSystematic review and meta-analysis.Data sourcePubMed, CINAHL, EMBASE, Cochrane Library, HINARI and...

Awareness: the Golden Key to Understanding Healthcare Seeking Behavior among Elderly Hypertensive Patients in Taft, Iran

Introduction: Healthcare seeking behavior is crucial for early detection and proper management of hypertension in the elderly. This study investigated the factors influencing healthcare seeking behavior among elderly hypertensive patients residing in Taft, Iran. Methods: This cross-sectional study recruited 230 hypertensive individuals aged 60 and above residing in Taft, Yazd Province, Iran. Participants were randomly selected and completed a questionnaire through face-to-face interviews. The questionnaire assessed their healthcare seeking behaviors and potential influencing factors. Data analysis was performed using SPSS software. Correlation tests and linear regression analysis were employed to identify significant relationships (p < 0.05). Results: A significant majority (70%) of participants reported always paying attention to symptoms of high blood pressure. When experiencing symptoms, over half (53.9%) of the participants indicated a preference for visiting health centers, general practitioners' offices, or emergency departments. Among the factors studied, awareness (B = 0.228) emerged as the most significant positive predictor of healthcare seeking behavior (p < 0.05). Other positive influences included decision-making autonomy (B = 0.177), prior experience with healthcare services (B = 0.131), and social support (B = 0.131) – all statistically significant at p < 0.05. Conversely, barriers to healthcare seeking had a negative and significant impact (B = - 0.064, p < 0.05). Collectively, the investigated factors explained 23% of the variation observed in healthcare seeking behavior among the elderly participants (R2 = 0.23). Conclusion: This study identified awareness of hypertension as the strongest predictor of healthcare seeking behavior in elderly patients. Additionally, providing accessible and supportive healthcare services can further encourage elderly hypertensive patients to seek necessary care.

Prevalence, awareness, treatment, control of hypertension among adults inhabited in the coastal area of Tianjin, China.

Hypertension has long been a worldwide health concern. Our aim was to investigate the prevalence, awareness, treatment, and control rates of hypertension and analyze the factors related to hypertension among adult residents of the coastal areas of Tianjin, China. This was a cross-sectional study. Adults aged 35 to 75 years were selected for the study using cluster random sampling methods. Detailed information was collected via face-to-face surveys and medical checkups. We assessed the rates of hypertension in the total population and sub-populations and used multivariable logistic regression to identify the factors associated with the prevalence and the control of hypertension. In total, 6305 participants aged 55.22 ± 10.37 years were included in this study. Approximately 49.8% (95% confidence interval [CI]: 48.5%-51.1%) of the population had hypertension; the prevalence increased with age and body mass index (all P < .001). Multivariable logistic regression showed that the odds ratio of hypertension was 5.93 times more in participants aged 65 to 75 years than in those aged 35 to 44 (95% CI: 4.85-7.26, P < .001). The odds ratio of hypertension was 3.63 times more in obese participants than in those of normal weight (95% CI: 3.08-4.28, P < .001). Additionally, the awareness, treatment, control, and control under-treatment rates of hypertension were 89.7%, 83.6%, 54.4%, and 60.5%, respectively. Factors associated with having controlled hypertension included sex, body mass index, and dyslipidemia (all P < .01). Our study identified that in the coastal area of Tianjin, China, about half have hypertension, also the region has high rates of hypertension awareness, treatment and control, and more than half of hypertension patients receiving treatment have controlled hypertension.

The Effect of an mHealth Self-Monitoring Intervention (MI-BP) on Blood Pressure Among Black Individuals With Uncontrolled Hypertension: Randomized Controlled Trial.

Hypertension is one of the most important cardiovascular disease risk factors and affects >100 million American adults. Hypertension-related health inequities are abundant in Black communities as Black individuals are more likely to use the emergency department (ED) for chronic disease-related ambulatory care, which is strongly linked to lower blood pressure (BP) control, diminished awareness of hypertension, and adverse cardiovascular events. To reduce hypertension-related health disparities, we developed MI-BP, a culturally tailored multibehavior mobile health intervention that targeted behaviors of BP self-monitoring, physical activity, sodium intake, and medication adherence in Black individuals with uncontrolled hypertension recruited from ED and community-based settings. We sought to determine the effect of MI-BP on BP as well as secondary outcomes of physical activity, sodium intake, medication adherence, and BP control compared to enhanced usual care control at 1-year follow-up. We conducted a 1-year, 2-group randomized controlled trial of the MI-BP intervention compared to an enhanced usual care control group where participants aged 25 to 70 years received a BP cuff and hypertension-related educational materials. Participants were recruited from EDs and other community-based settings in Detroit, Michigan, where they were screened for initial eligibility and enrolled. Baseline data collection and randomization occurred approximately 2 and 4 weeks after enrollment to ensure that participants had uncontrolled hypertension and were willing to take part. Data collection visits occurred at 13, 26, 39, and 52 weeks. Outcomes of interest included BP (primary outcome) and physical activity, sodium intake, medication adherence, and BP control (secondary outcomes). We obtained consent from and enrolled 869 participants in this study yet ultimately randomized 162 (18.6%) participants. At 1 year, compared to the baseline, both groups showed significant decreases in systolic BP (MI-BP group: 22.5 mmHg decrease in average systolic BP and P<.001; control group: 24.1 mmHg decrease and P<.001) adjusted for age and sex, with no significant differences between the groups (time-by-arm interaction: P=.99). Similar patterns where improvements were noted in both groups yet no differences were found between the groups were observed for diastolic BP, physical activity, sodium intake, medication adherence, and BP control. Large dropout rates were observed in both groups (approximately 60%). Overall, participants randomized to both the enhanced usual care control and MI-BP conditions experienced significant improvements in BP and other outcomes; however, differences between groups were not detected, speaking to the general benefit of proactive outreach and engagement focused on cardiometabolic risk reduction in urban-dwelling, low-socioeconomic-status Black populations. High dropout rates were found and are likely to be expected when working with similar populations. Future work is needed to better understand engagement with mobile health interventions, particularly in this population. ClinicalTrials.gov NCT02955537; https://clinicaltrials.gov/study/NCT02955537. RR2-10.2196/12601.

Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing.

Hypertension is highly prevalent in chronic kidney disease (CKD), posing a significant but modifiable risk for adverse clinical outcomes. This study explored the prevalence, awareness, treatment, and control of hypertension in older Irish adults with CKD. Data were analysed from participants in Wave 1 of The Irish Longitudinal Study on Ageing (TILDA) who were aged 50 years and older. CKD was defined as eGFR <60ml/min/1.72 m2, hypertension defined as systolic blood pressure (SBP) ≥140mmHg and/or diastolic blood pressure (DBP) ≥90mmHg and/or self-reported use of antihypertensive medication. Participant awareness and treatment of hypertension was based on self-report and SBP/DBP <140/90mmHg. Multivariable logistic regression examined relationships with awareness, treatment, and control of hypertension expressed as adjusted odds ratios. Prevalence of hypertension was significantly higher in participants with CKD than without (81.9%vs 59.7%, P<.001). Among hypertensive individuals, 70.1% (95% CI: 65.8-74.1) were aware, 83.5% (95% CI 80.0-86.6) were on treatment, yet blood pressure control <140/90mmHg and SBP <120mmHg were achieved in only 49.3% (CI 44.0-54.7%) and 17.9% (CI 14.4-22.1), respectively. In multivariable analysis, advancing age 1.05 (CI 1.01-1.10), obesity 6.23 (CI 2.51-15.5), diabetes 5.78 (CI 1.55-21.5), and cardiovascular disease 9.89 (CI 3.27-29.9) were associated with higher odds of treatment, while cardiovascular disease 2.35 (CI 1.39-3.99) and combination antihypertensive therapy 1.76 (CI 1.03-3.01) were associated with blood pressure control. The prevalence of hypertension is substantial in older Irish adults with CKD; however, control is poor. Approximately, one-third of participants were unaware of their hypertensive status and approximately one-fifth were untreated.

Disparities in awareness and treatment among women with hypertension: Insights from the American Heart Association Research Goes Red Registry

Hypertension is an important modifiable risk factor for cardiovascular disease and affects nearly one-third of women in the U.S. Prior research has demonstrated declining rates of blood pressure (BP) control nationally among women, and there are significant racial and ethnic disparities in both hypertension prevalence and outcomes among U.S. women. However, national-level data on attitudes and awareness of women with hypertension are limited. To address this gap, data were analyzed from participants with self-reported hypertension enrolled in the American Heart Association's Research Goes Red Registry. Of 6170 women who responded as of February 2023, 1835 (30 %) reported a history of hypertension. The top health concerns reported among women with hypertension were weight, healthcare access and costs, and hypertension. Health concerns varied significantly by age, race, and ethnicity; younger women and Black and Hispanic women were more likely to report hypertension as their top concern. Among women with self-reported hypertension, 77 % reported knowing their BP, and 90 % reported being on an anti-hypertensive. Black and Hispanic women were less likely to know their BP compared to White women. Younger women were less likely to be treated for hypertension, and there were also disparities in treatment by employment status and among uninsured women. In this national registry of women in the U.S., gaps and disparities exist in awareness and treatment of hypertension, highlighting targets for quality improvement in hypertension care for women.

Awareness, treatment, and control of hypertension among women at risk or living with HIV in the US South.

Timely control of hypertension is vital to prevent comorbidities. We evaluated the association of race/ethnicity and HIV infection with incident hypertension outcomes, including awareness, treatment, and control. We evaluated cisgender women living with HIV and sociodemographically matched women living without HIV recruited into four Southern sites of the Women's Interagency HIV Study (WIHS) (2013-2019). We calculated measurements of the time to four events or censoring: incident hypertension, hypertension awareness, hypertension treatment, and hypertension control. Hazard ratios for race/ethnicity and HIV status were calculated for each outcome using Cox proportional-hazards models adjusted for sociodemographic, behavioral, and clinical risk factors. Among 712 women, 56% were hypertensive at baseline. Forty-five percentage of the remaining women who were normotensive at baseline developed incident hypertension during follow-up. Non-Hispanic white and Hispanic women had faster time to hypertension control compared with non-Hispanic black women ( P = 0.01). In fully adjusted models, women living with HIV who were normotensive at baseline had faster time to treatment compared with normotensive women living without HIV ( P = 0.04). In our study of women in the US South, non-Hispanic black women became aware of their hypertension diagnosis more quickly than non-Hispanic white and Hispanic women but were slower to control their hypertension. Additionally, women living with HIV more quickly treated and controlled their hypertension compared with women living without HIV.

May Measurement Month 2021: an analysis of blood pressure screening results from China.

We reported findings from participants screened during the May Measurement Month 2021 in China, which aimed to raise awareness of raised blood pressure (BP), and to investigate the risk factors of BP. The study participants were adults (≥18 years), ideally in whom BP had not been measured in the previous year. Blood pressure was measured three times consecutively with 1 min intervals in the sitting position, using a validated upper-arm cuff automated BP monitor (Omron HEM-7081IT), and transmitted to a central cloud database via a smartphone app. The measurement was performed in 218 844 participants in 183 sites across 31 China provinces. The mean (standard deviation) age was 47.0 (15.7) years, and 51.8% (n = 113 466) were women. The mean systolic/diastolic BP was 120.2/77.5 mmHg. Among 57 178 (26.1%) participants with hypertension, the awareness, treatment, and control rates of hypertension were 30.4% (n = 17 354), 28.7% (n = 16 369), and 17.1% (n = 9743), respectively. After adjustment for age, sex, and use of antihypertensive medication, both systolic and diastolic BP were significantly (P ≤ 0.01) higher in current smokers (n = 22 344, +0.4/+0.7 mmHg) and with moderate (n = 4780, +1.4/+4.2 mmHg) or daily alcohol intake (n = 2427, +1.3/+2.5 mmHg). Blood pressure was lower in those reporting regular exercise (n = 32 328, -2.2/-1.4 mmHg). In addition, individuals with previous COVID-19 vaccination had lower systolic and diastolic BP (n = 88 945, -1.8/-1.5 mmHg, P ≤ 0.001). In conclusion, our study showed that long-term large-scale screening for hypertension is feasible, and there is a strong association between BP and major lifestyle factors.

Blood pressure screening results from May Measurement Month 2021 in Vietnam.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative to raise awareness of high BP and acts as a temporary solution to the worldwide shortage of screening programmes. We aimed to screen for hypertension and cardiovascular risk factors in people aged ≥18 years in the community, thereby defining the proportion of participants with elevated BP and assessing the awareness and the effectiveness of its treatment. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2021. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. From May 2021 to June 2021, through three cities/provinces in Vietnam (due to the COVID-19 pandemic), 2572 individuals with mean age 51.5 (SD ±15.7) years were screened. After multiple imputation, 929 (36.1%) had hypertension. Of individuals not receiving antihypertensive medication, 206 (11.2%) were hypertensive. Of individuals receiving antihypertensive medication, 415 (57.4%) had uncontrolled BP (≥140/90 mmHg). The MMM21 BP screening campaign was undertaken in Vietnam during the COVID-19 pandemic. Undiagnosed and uncontrolled hypertension in Vietnam remains a substantial health problem. Local campaigns applying standardized methods such as MMM21 will be beneficial to screen for a significant number of individuals with raised BP and increase awareness of hypertension.

Effectiveness of Tempe Yogurt and Tempe Juice on Pregnancy Hypertension

Data from the Global World Health Organization shows that hypertension is currently a global concern. Hypertension is caused by cardiovascular disease, and all of them cause death. According to report, only 54 percent of adults with hypertension were diagnosed, 42 percent received treatment, and only 21 percent had treatable hypertension. This needs to be underlined that efforts to increase awareness and management of hypertension are required. One of the non-communicable diseases that causes most deaths is hypertension. Based on the performance report of the South City Community Health Center, there were relatively high cases of hypertension in pregnant women in the last six months, namely 10 cases. Age, genetic factors, and parity can cause hypertension in pregnant women. This study aims to determine the effectiveness of tempeh yogurt and tempeh spice juice against hypertension in pregnancy in the South City Health Center Working Area. A quantitative study with a quasi-experimental two-group pretest-posttest design was conducted from April to September 2023. Samples were taken using purposive sampling of 40 samples, where the samples were divided into two intervention groups, namely 20 respondents who were given intervention using tempe yogurt three times a day, 200 ml, and 20 respondents were given 200 ml of tempeh spice yogurt three times a day. The results of the analysis showed that respondents aged more than 35 years (45 percent) in group A and aged 20-35 years (40 percent) in group B. Parity less than 2- more than 4 (65 percent) in group A, parity 2-4 in group B. There was no history of hereditary hypertension (85 percent) in group A and (80 percent) in group B. There was a significant difference before and after the tempeh yogurt and tempeh spice juice intervention on systolic and diastolic blood pressure (p less than 0.05). There was a significant difference in the reduction in systolic blood pressure after being given tempeh yogurt and tempeh spice juice (p less than 0.05). It can be concluded that one effort to reduce pregnancy hypertension is by consuming tempeh yogurt and tempeh spice juice regularly.

Treatment of a Population of 32 Patients with ALS and Spine Injury Grafting Stem Cells through Neuroendoscopy

Introduction: Isotretinoin, a potent acne treatment, has notable side effects, including depression and teratogenicity. Idiopathic Intracranial Hypertension (IIH), characterized by elevated intracranial pressure, has been linked to isotretinoin. This study explores the awareness of IIH among isotretinoin users in Saudi Arabia, addressing a crucial healthcare concern. Methodology: It is a cross-sectional study conducted in Saudi Arabia using a self-administered questionnaire shared via social media and in dermatology clinics. Data is cleaned in excel and analyzed in IBM SPSS 29. Results: Our study included 420 Isotretinoin users, primarily females (76.9%), aged 18-25 (64.3%), from Eastern (29.5%) and Western (26.7%) regions, with high school (49.3%) and university graduates (46.7%). All used Isotretinoin for acne treatment, with varied usage durations. Some used additional medications like Vit. A (Retinol) (23.1%). Notably, only 26.7% were aware of Idiopathic Intracranial Hypertension (IIH), and 18.1% believed Isotretinoin increased IIH risk. Educational level significantly impacted IIH awareness (p&lt;0.001), while age, gender, and regional factors had less impact. Acne presence did not notably affect IIH awareness. Conclusion: Our study emphasizes the necessity of enhancing Idiopathic Intracranial Hypertension (IIH) awareness among Isotretinoin users. Despite some sociodemographic influences on awareness, there is a pervasive lack that requires targeted education for safer medication use and improved patient outcomes.

Prevalence, Patient Awareness, Treatment, and Control of Hypertension in Canadian Adults With Common Comorbidities

BackgroundWhether certain medical conditions are associated with blood pressure (BP) treatment and control is unclear. MethodsUsing the Canadian Health Measures Survey (2007-2019), BP was assessed according to the presence of selected comorbidities, including prior heart attack or stroke, dyslipidemia, chronic kidney disease, diabetes mellitus, obstructive sleep apnea, and overweight or obesity. ResultsA total of 5,841,453 people, representing 23.0% (95% confidence interval [CI] 21.7%-24.2%) of Canadian adults, were hypertensive. The adjusted odds ratio (aOR) of having hypertension treated and controlled was higher in people with the following conditions, as compared to people without these conditions: a prior heart attack or stroke (aOR 3.15; 95% CI 2.31-4.31); dyslipidemia (aOR 2.51; 95% CI 1.96-3.21); obstructive sleep apnea (aOR 1.95; 95% CI 1.19-3.21); overweight or obesity (aOR 1.51; 95% CI 1.18-1.94); chronic kidney disease (aOR 1.49; 95% CI 1.13-1.95); and diabetes (aOR 1.44; 95% CI 1.12-1.86). Individuals without any of these comorbidities were less likely to have BP that is treated and controlled (aOR 0.34; 95% CI 0.25-0.48). Moreover, the prevalence of BP treatment and control was low among many people without prior heart attack or stroke, even those with a moderate (aOR 0.25; 95% CI 0.17-0.37) or high (aOR 0.10; 95% CI 0.06-0.16) Framingham risk. ConclusionsLarge differences in levels of BP control exist across comorbidity profiles, and the greatest gaps are seen in individuals without recognized comorbidities, even those who have a moderate-to-high Framingham risk. Efforts to optimize BP control and narrow care gaps, especially in individuals without recognized comorbidities, are necessary to reduce the burden of cardiovascular disease and premature death in Canada.

Hypertension in the Polish elderly: Insights into prevalence, awareness, treatment, and control from the NOMED-AF study.

Hypertension is a significant global health issue, disproportionately affecting the elderly population. In Poland, the rapid aging of the population underscores the need for updating data on the epidemiology of hypertension in the elderly. This study aimed to investigate the prevalence, awareness, treatment, and control of hypertension among individuals aged 65 and older in Poland. The NOMED-AF study, a cross-sectional survey conducted from March 2017 to March 2018, enrolled a representative sample of 3014 participants aged 65 and over, using a multistage, stratified, and clustered sampling method. Data collection included standardized questionnaires and physical measurements carried out by trained nurses. Hypertension was diagnosed per the 2018 European Society of Hypertension/European Society of Cardiology guidelines. The study showed a hypertension prevalence of 82.5% in females and 78.3% in males aged 65 and older. Awareness of hypertension was high across all age and sex groups, with 86.2% of women and 83.4% of men being aware of their condition. Treatment rates were 84.8% in women and 80.5% in men. Optimal control of blood pressure among those treated was achieved in 40.3% of women and 45.6% of men. Women over 80 achieved optimal blood pressure control less frequently than men. The results highlight the high prevalence and suboptimal control of hypertension in Poland's elderly population, pointing to a significant public health challenge. Despite high rates of treatment, management of hypertension remains inadequate, which emphasizes the need for enhanced strategies in hypertension care, particularly for elderly women.

Situational analysis of hypertension management at primary health care level in São Paulo, Brazil: population, healthcare professional and health system perspectives

BackgroundGovernment-led, population-wide initiatives are crucial for advancing the management of hypertension − a leading cause of cardiovascular disease (CVD) morbidity and mortality. An urban population health initiative was conducted against this backdrop, focussing on hypertension in the primary health system in São Paulo, Brazil. Within the frame of the initiative and under the supervision and leadership of the municipal health authorities, a situational analysis was conducted on the needs in hypertension management, marking the first phase of a Design Thinking process. This article describes the situational analysis process and presents the identified elements to be strengthened considering hypertension diagnosis, treatment and control.MethodsFirst, a mixed-methods approach was used, starting with a literature review of municipal hypertension data followed by meetings (N = 20) with the local public health administration to assess health system level components. To investigate activities on hypertension diagnosis, treatment and control, nine primary healthcare units were selected from two districts of São Paulo city– Itaquera and Penha– which received an online form addressed to managers, participated in conversation circles of staff and patients, and underwent shadowing of community health agents.ResultsData gave rise to two main outputs: (i) a patient care journey map; and (ii) a matrix summarizing the identified needs at patient, healthcare professional and health system level for diagnosis, treatment and control of hypertension. Patient awareness and knowledge of hypertension was found to be insufficient and its management needs to be improved. For health professionals, disease awareness, technical training, more time dedicated to patients, and simplified guidelines and clinical decision-making tools for hypertension management were identified as principal needs. The situational analysis found that the healthcare systems efficiency might be improved by establishing defined treatment and care delivery goals with a focus on outcomes and implemented through action plans.ConclusionsThis situational analysis identified several needs related to hypertension control in São Paulo that are in line with global challenges to improve the control of CVD risk factors. Findings were also confirmed locally in an expansion phase of this situational analysis to additional primary care facilities. As a consequence, solutions were designed, promptly taken up and implemented by the municipal health secretariat.

Cardiometabolic factors and population risks of cardiovascular disease in community-dwelling adults with varied blood pressure statuses.

To examine the differential associations between cardiometabolic risk factors and cardiovascular disease (CVD), and to evaluate the population-attributable fractions (PAFs) for CVD among community-dwelling adults with varied blood pressure (BP) statuses. This prospective cohort study included participants without prevalent CVD from a subcohort of the China Patient-Centred Evaluative Assessment of Cardiac Events Million Persons Project. Participants were divided into four BP groups according to the American College of Cardiology/American Heart Association guidelines. The study exposure comprised the selected cardiometabolic risk factors, including waist circumference (WC), body mass index, (BMI) heart rate, fasting blood glucose (FBG), low-density lipoprotein cholesterol, and remnant cholesterol. The outcome was hospitalizations for CVD. Cox proportional hazard models were conducted, and the PAFs were calculated in the analysis. Among the 94 183 participants (39.0% were men, mean age: 54.2 years), 26.6% had Stage 1 hypertension and 30.8% had Stage 2 hypertension. A total of 6065 hospitalizations for CVD were captured after a median follow-up of 3.5 years. BP (per 1-standard deviation [SD]: hazard ratio [HR] 1.34, 95% confidence interval [CI] 1.29, 1.40), FBG (per 1-SD: HR 1.16, 95% CI 1.14, 1.19) and WC (per 1-SD: HR 1.41, 95% CI 1.36, 1.47) were three major contributors to CVD events. BP status significantly modified the associations of abdominal obesity, suboptimal BMI, suboptimal heart rate and abnormal FBG with CVD, with stronger associations with CVD observed in optimal BP groups compared to hypertensive groups (p for risk factor-by-BP group interaction <0.05). Participants with all cardiometabolic risk factors were at the highest risk for CVD, accounting for 35.6% (95% CI 30.0, 40.8) of the PAF for CVD. Among the risk factors, BP control explained the highest PAF for CVD (15.1%, 95% CI 8.2, 21.4) The overall PAFs of cardiometabolic risk factors for CVD were higher among the normotensive participants compared to the hypertensive participants. The awareness and control rates of hypertension were extremely low among Southern Chinese adults. BP status significantly modified the associations between cardiometabolic risk factors and CVD, and the overall PAFs for CVD were higher among people with normal BP. Dedicated efforts are needed to improve the management of cardiometabolic factors.

Influencing factors of hypertension and diabetes care cascade: a qualitative study

Objective: Employing the cascade care model, this qualitative study explores determinants influencing the cascading care stages of hypertension and diabetes by interviewing various stakeholders. Methods: In July 2023, purposive sampling was employed to recruit participants from Gongyi and Wugang cities in Henan Province, and Linqu County in Weifang City, Shandong Province. Semi-structured in-depth interviews were conducted with representatives of policymakers, healthcare institution managers, providers, and patients with hypertension and diabetes.And thematic analysis was performed using both inductive and deductive approaches. Results: A total of 82 individuals were interviewed, with an age range of (53.8±12.0) years, among which 48 (58.5%) were male; including 5 policymakers, 10 institutional managers, 20 healthcare providers, and 47 patients with hypertension and diabetes. The study identified both barriers and facilitating factors at the patient, healthcare provider, and system levels across various stages: awareness, screening, diagnosis, treatment, long-term management, and control of hypertension and diabetes. Conclusion: By delineating and analyzing the barriers and facilitators at each stage of hypertension and diabetes care, this study lays the groundwork for the development of effective, feasible, and sustainable implementation pathways, with significant implications for the enhanced management of hypertension and diabetes in China.

MAY MEASUREMENT MONTH 2017-2023 IN CHINA

Objective: We investigated status of hypertension in a large opportunistic screening study in China from 2017 to 2023. Design and method: Data was derived from May Measurement Month (MMM). MMM China project strictly followed the international MMM protocol. Study participants had to be &gt;= 18 years of age and had ideally not taken blood pressure for &gt;= 1 year. Blood pressure was measured three times consecutively in the sitting position with a 1-minute interval, using a validated electronic BP monitor or mercury sphygmomanometer. Trained volunteer investigators administered a questionnaire to collect information on medical history, lifestyle, and use of medications. Results: Since 2017, more than 1600 measurement sites have been set up, and 1.7 million adult blood pressure measurements have been completed. Mean systolic blood pressure and diastolic blood pressure over the years is around 119-124mmHg, and 74-81 mmHg, respectively. From the results of MMM program, about 30% (24.7% to 29.2%) had hypertension. Through 3 years of efforts, the awareness (46.9% in 2017 to 51.5% in 2019), treatment (40.7% in 2017 to 48.4% in 2019), and control (15.3% in 2017 to 29.1% in 2019) rates of hypertension in China have improved. However, after COVID-19, the awareness (45.3% in 2020 to 16.0% in 2023), treatment (39.7% in 2020 to 14.3% in 2023) and control (24.2% in 2020 to 7.1% in 2023) rate of hypertension have declined. The main barriers to blood pressure awareness in China included age, gender, and body mass. The awareness of hypertension was higher in patients with comorbid diseases, such as diabetes mellitus, coronary heart disease, stroke or TIA, or the use of statins, than those without. The main barriers affecting hypertension control in China included age, gender, smoking and low proportion of combination therapy. Conclusions: The situation of low control rate of hypertension needs to be changed as soon as possible. Several modifiable factors as barriers to blood pressure control in China, such as current smoking, and the under-use of combination therapy warrants attention.

Prevalence, awareness, and control of hypertension in Greece before and after the COVID-19 pandemic: May Measurement Month survey 2019–2022

ObjectiveThe COVID-19 pandemic had an adverse impact on several cardiovascular risk factors. This study investigated the prevalence, awareness and treatment of hypertension in Greece before and after the pandemic. Data were collected in the context of the May Measurement Month (MMM) global survey initiated by the International Society of Hypertension. MethodsAdult volunteers (age ≥ 18 years) were recruited through opportunistic screening in public areas across cities in Greece in 2019 and 2022. Medical history and triplicate sitting blood pressure (BP) measurements were taken using validated automated upper-arm cuff devices. The data were uploaded to the international MMM cloud platform. Hypertension was defined as systolic BP ≥ 140 mm Hg and/or diastolic ≥90 mm Hg and/or self-reported use of drugs for hypertension. The same threshold was used to define uncontrolled BP in treated individuals. ResultsData from 12,080 adults were collected (5,727/6,353 in MMM 2019/2022; men 46/49%, p < 0.01; mean age 52.7 ± 16.6/54.8 ± 16.2, p < 0.001; smokers, 24.7/30.5, p < 0.001; diabetics 12/11.5%, p = NS; cardiovascular disease 5/5.8%, p = NS). The prevalence of hypertension was 41.6/42.6% (MMM 2019/2022, p = NS), with 21.3/27.5% of individuals with hypertension being unaware of their condition (p < 0.001), 5.6/2.4% aware untreated (p < 0.001), 24.8/22.1% treated uncontrolled (p < 0.05), and 48.3/47.8% treated controlled (p = NS). ConclusionIn Greece, the COVID-19 pandemic did not appear to affect the prevalence and control of hypertension; however, the rate of undiagnosed hypertension was higher after the pandemic. National strategies need to be implemented for the early detection and optimal management of hypertension in the general population in Greece.

Chronic Kidney Disease Risk Awareness, Dietary Intake, and Food Security Among Black Male College Students

ObjectivesNutrition, lifestyle factors, and awareness of chronic kidney disease (CKD) risk are vital tools for preventing or delaying its development and progression in Black American (BA) males. Few published studies assess awareness of CKD risk in BA male college students despite being at high risk. This study aimed to 1) assess the awareness of CKD risk among BA male college students and 2) identify dietary and lifestyle habits related to CKD risk. MethodsThis was a cross-sectional online survey utilizing a network sampling technique. Inclusion criteria were self-identification as a Black American male and current enrollment in a university. Participants were recruited through publicly available social media sites and emails. The online questionnaire contained demographic, health status, and food security items. Pearson’s correlations explored associations between continuous variables; independent samples t-tests compared mean scores of responses between perceived risk of disease groups. ResultsSixty-seven participants completed the survey. Only 22.4% perceived they were at increased risk for kidney disease, while 49.3% felt at increased risk for developing hypertension (HTN). More respondents (32.8%) also felt at increased risk for developing diabetes than kidney disease. Dietary sodium restriction was reported by 34.3%, while only 14.9% had been advised to do so by a healthcare provider. Half of the respondents were deemed food insecure, and 17.86% were categorized as experiencing very low food security. ConclusionAwareness of CKD risk is low for BA male college students and lags behind awareness of HTN and diabetes risk. There may be a lack of knowledge regarding CKD as a long-term complication of HTN and diabetes. Dietary sodium restriction is marginal, and food security is a significant challenge in this high-risk group. Educational initiatives are needed to increase awareness of CKD risk among BA male college students.

SEX DIFFERENCES IN HYPERTENSION PREVALENCE, TREATMENT AND CONTROL IN OLDER PEOPLE IN GERMANY: RESULTS OF THE NATINAL EXAMINATION SURVEY GESUNDHEIT 65+

Objective: As hypertension is closely linked to cardiovascular events, blood pressure (BP) levels and management in populations are a vital public health concern. A gender gap with higher awareness, treatment and control of hypertension in women, especially in younger women, has been repeatedly reported. We analyze recent national BP data of the Gesundheit 65+ study in older and very old men and women in Germany 2022-2023. Design and method: Nationally representative examination survey of the population aged 65 years and older residing in Germany. We analysed self-reported hypertension diagnoses, the mean of the second and third standardized oscillometric BP measurements (Mobil-O-Graph) with one of five cuffs according to upper arm circumference and Anatomical Therapeutic Chemical- (ATC) coded medication in the past 7 days. Hypertension was defined as mean systolic BP (SBP) at or above 140 mm Hg, or mean diastolic BP (DBP) at or above 90 mm Hg, or use of antihypertensives (ATC-codes C02 antihypertensives, C03 diuretics, C07 beta-blockers, C08 calcium-channel blockers or C09 ACEI and ARB) in participants with self-reported hypertension diagnosis. Awareness was defined as self-reported BP diagnosis in those with hypertension according to study definition. Provisional population weights were used. Results: BP was measured and hypertension status defined in 743 men and 686 women aged 65 to 100 years. The prevalence of hypertension according to our study definition was 58.3% [95% CI 53.2-63.3] in men and 59.5% [53.8-64.9] in women. There were no sex differences in awareness among hypertensives (men 81.7%, women 81.2%), nor in treatment among aware hypertensives (97.5% in men and women). However, control among treated hypertensives differed considerably: while 75.7% [69.2; -81.2] of men with treated hypertension had BP at or below 140/90, control among treated in women was only at 61.4% [54.2-; 68.1]. Conclusions: Our 2022-2023 national blood pressure data of people aged 65 years and older in Germany suggest a new gender gap with less hypertension control in older women compared to older men which was not yet apparent a decade ago and stands in contrast to findings in younger adults across many studies.