Hypertension Screening Program Research Articles

Arterial Stiffness Associated with Long-Term Major Adverse Cardiac Events in Patients of Primary Aldosteronism.

As a novel parameter for risk prediction, artery stifiness may hold promise in refining risk assessment strategies, guiding therapeutic interventions, and ultimately improving cardiovascular outcomes in patients with primary aldosteronism (PA). To investigate the correlation between brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, and the occurrence of major adverse cardiovascular events (MACEs) in patients with PA under a primary prevention design. Among the 830 patients included in the final analysis, 113 (13.6%) developed inciden t MACEs over a median follow-up period of 5.8 years, with a crude rate of 23.2 per 1000 person-years. Multivariable Cox proportional hazards analyses revealed that baPWV was an independent risk factor for incident MACEs, with an adjusted hazard ratio of 1.01 (P = 0.028). The generalized additive model identified a cut-off value of 2000 cm/s for baPWV, which was independently associated with incident MACEs, with a hazard ratio of 1.72 (P = 0.045). Subgroup analyses revealed that PA patients who were mineralocorticoid receptor antagonist (MRA) users and had high baPWV had a significantly higher risk of incident MACEs (HR = 3.34; P < 0.001), while the risk was not significant in patients who underwent adrenalectomy (P = 0.062). Furthermore, the addition of baPWV to the cardiovascular Framingham risk score significantly improved the category-free net reclassification index (0.308, P < 0.001). Our study found that 13.6% of patients with PA developed MACEs after a median follow-up of 5.8 years. Our findings highlight the potential utility of baPWV as a tool for risk stratification in PA patients in primary prevention, whereas adrenalectomy appears to mitigate this risk irrespective of baPWV. The measurement of baPWV could be a valuable addition to hypertension screening programs for primary prevention, providing additional predictive information for the potential occurrence of MACEs.

Prevalence of newly diagnosed hypertension and its associated factors in an opportunistic screening program in Addis Ababa, Ethiopia: an institution-based cross-sectional study

BackgroundHypertension is a recognized risk factor that underlies the epidemic of cardiovascular diseases. Guidelines, including those from the European Society of Hypertension, recommend opportunistic screening for hypertension in all adults. However, there have been no institution-based studies on the prevalence of hypertension and its associated factors with an opportunistic screening program in Ethiopia. Hence, this study aimed to assess the prevalence of newly diagnosed hypertension and its associated factors in an opportunistic screening program in Ethiopia.MethodsThis was an institution-based cross-sectional study conducted on adult participants in an opportunistic hypertension screening program at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from November 1, 2023, to February 1, 2024. Data were collected using a structured questionnaire, constructed as per the WHO STEPwise approach to non-communicable disease risk factor surveillance (STEPS). The data was analyzed using Statistical Package for Social Sciences (SPSS), version 26. Descriptive analysis was used to compile the sociodemographic and clinical characteristics of the participants, and logistic regression analyses were performed to determine the factors associated with hypertension.ResultsA total of 301 adult participants were included in this study. The mean age of the participants was 47.6 years (standard deviation: 13.5), and 62.5% were males. The prevalence of newly diagnosed hypertension was 36.2% (95% confidence interval [CI]: 5.6, 66.8). Male sex (adjusted odds ratio (AOR) = 2.06, 95% (CI): 1.05, 4.04), being married (AOR = 4.8, 95% CI: 1.84, 2.77) or widowed (AOR = 5.14, 95% CI: 1.23, 1.46), less frequent intake of vegetables and/or fruits [< 3 days per week (AOR = 2.88, 95% CI: 1.12, 7.39), and 3 to 5 days per week (AOR = 2.22, 95% CI: 1.02, 4.86)], physical inactivity (AOR = 2.26, 95% CI: 1.21, 4.22), and body mass index (AOR = 1.17, 95% CI: 1.09, 1.26), had significant associations with hypertension.ConclusionThis study demonstrated a high prevalence of newly diagnosed hypertension in an opportunistic screening program in Addis Ababa, Ethiopia. It also revealed that most of the factors significantly associated with hypertension were modifiable, underscoring the importance of promoting lifestyle changes. Most importantly, expanding institution-based opportunistic screening programs could be an effective approach to maximize the detection of hypertension and improve access to its treatment.

Screening for hepatitis B in the Bronx West African community with a blood pressure cuff: a cohort study

Hepatitis B (HBV) and hypertension (HTN) are prevalent in West Africa (WA). Inadequate control is common, and evaluation and management are challenging among immigrants due to unfamiliarity with the United States (US) healthcare system. While HBV is stigmatised, HTN is recognised as an important condition. We describe how a HTN screening program can facilitate HBV screening in the Bronx WA community. Thirty-minute HTN educational programs were delivered in collaboration with faith-based organisations, and 5-min presentations were presented upon request at community gatherings. Arrangements were made for those interested in a clinic visit where a questionnaire was completed, blood pressure (BP) measured, a free BP cuff provided, HBV testing performed, and referrals made. For those without ongoing care, insurance was arranged, and linkage to care provided. Seven 30-min and five 5-min presentations were conducted. After the 30-min presentation, 204 of 445 attendees (45.8%) requested a visit, and 68 (33.3%) attended the visit. After the 5-min presentation, 80 requested a visit and 51 (63.8%) attended the visit. A BP>140/90mmHg was present in 122 individuals (48.4%), including 43 (17.1%) without a history of HTN and 39 (15.5%) with BP>160/90mmHg. All except two who reported previous testing agreed to HBV testing. 19 (7.5%) were hepatitis B surface antigen positive. Transition into ongoing care was provided for 60 (33.9%) with HTN who were not integrated into the US healthcare system. HTN screening with a free BP cuff promotes HBV screening and US healthcare integration. No funding.

Geographical Disparities in Hypertension Incidence Rate in Iran 2004-2016: Bayesian Spatial Analysis

Introduction: Cardiovascular diseases such as coronary heart disease, heart failure, arrhythmia, and cardiomyopathy all include hypertension as a key risk factor. Research has shown that the early detection and treatment of hypertension and its risk factors, as well as public health policies to reduce behavioral risk factors, have led to a gradual reduction in mortality caused by heart disease and stroke in high-income countries in the past three decades. Trends in hypertension incidence have been monitored at the national level in Iran. The aim of this study examine province-level disparities in Hypertension incidence from 2004 to 2016. Methods: Use the Non-Communicable Diseases Risk-Factors Surveillance in the Islamic Republic of Iran STEPs registry data. to estimate the incidence rate of hypertension for all provinces in 2004, 2006-2009, 2011, and 2016 using a Bayesian spatial model with Markov chain Monte Carlo algorithm in OpenBUGS version 3.2.3 and R version 4.2.2. Results: The estimated Hypertension incidence rate in total increased from 19.87 per 1000 people (95% credible interval 14.28, 25.48) in 2004 to 193.02 (171.92, 220.48) in 2016. According to the estimates of 2016, we found that the provinces of Markazi, Ardabil, and Semnan had the highest rate of hypertension, and the provinces of Hormozgan, and Sistan-Baluchistan had the lowest rate. Our findings show that Khorasan, North, Alborz, and Semnan have the most significant percentage change in incidence rate from 2004-2016. Conclusion: To reduce the prevalence of hypertension in Iranian regions, it is crucial to develop regular hypertension screening programs, especially among the elderly

MASKED HYPERTENSION IN PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE – AN UNDERESTIMATED RISK?

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) and hypertension are major cardiovascular risk factors sharing a bi-directional relationship. Although nearly half of MASLD patients are suffering from arterial hypertension, data on the prevalence of different hypertension phenotypes (e.g. masked hypertension) in this patient population are scarce. Masked hypertension, which is defined by normal office blood pressure but elevated blood pressure in the ambulatory 24-hour blood pressure measurement (24-h-ABPM), often remains undetected, although it has a comparable risk for adverse cardiovascular events as sustained hypertension. Therefore, the identification of this hypertension phenotype in MASLD patients seems highly relevant. Design and method: To analyze the prevalence of masked hypertension and to improve hypertension management in MASLD patients we integrated a 24-h-ABPM-based hypertension screening and control program among MASLD patients in our outpatient liver department. A total of 226 MASLD patients were recruited during regular follow-up visits and recording of office blood pressure and 24-h-ABPM measurements were performed according to a standardized protocol. Results: For the final analysis, 218 data sets were evaluated. The median age of the included 218 patients was 51 years, 48.2% were female. 101 (46.3%) MASLD patients had prior history of hypertension. At the time of ABPM 93 (92.1%) of these patients received antihypertensive treatment. Masked hypertension was identified in 46 (21.1%) MASLD patients, 20 (43.5%) of whom were receiving antihypertensive treatment (masked uncontrolled hypertension). Interestingly, 14 (30.4%) MASLD patients with masked hypertension had isolated nocturnal masked hypertension. Furthermore, a non-dipping blood pressure pattern was recognized in 28 (60.9%) MASLD patients with masked hypertension. Conclusions: Due to the high rates of masked hypertension and abnormal nocturnal blood pressure dipping, which both represent important risk factors for adverse cardiovascular events, the establishment of hypertension screening and management programs in this high-risk population seems urgently needed. Controlled hypertension reduces the risk of cardiovascular events in this vulnerable population and, due to the strong link between MASLD and hypertension, possibly also slow the progression of MASLD to advanced liver fibrosis or cirrhosis.

Abstract P319: Effects of Environment and Noise on Blood Pressure Readings: The (Decibel(s)) Trial

Background: While guidelines emphasize quiet settings for blood pressure (BP) measurement, large-scale hypertension screening is often conducted in noisy, public spaces (e.g., health fairs). However, the influence of noise and environment on BP readings is unknown. Methods: We conducted a randomized crossover trial of community dwelling adults in Baltimore, MD to determine the BP effect of noise and public environment. Participants were randomly assigned to the order of triplicate BPs in 3 spaces: private quiet office (private quiet 1 [reference]); noisy public space (public loud); noisy public space + earplugs (public quiet). To account for intrinsic BP variability, all participants underwent a 4th set of BP measurements in a private quiet office (private quiet 2 ). Between each set of triplicate BPs with a WelchAllyn ProB 2000 device and appropriately sized cuff, participants walked for ≥2 minutes, rested for 5 minutes, and had arm/back/feet supported. We conducted difference in difference analysis, overall and stratified by baseline SBP (≥ vs. &lt; 130mmHg) and age (≥ vs. &lt;60yrs). Results: N=108, mean age 56 (SD 17) yrs (55% ≥60 years), 91% Black race, and 44% female. 45% had SBP≥130mmHg. Mean private quiet 1 and private quiet 2 BP was 129/74 and 127/74 mmHg (SBPΔ -1.6 (SD 7.1)/DBPΔ -0.2 (SD 4.0)). The average noise level in public loud was 74 db and in private quiet was 37 db. Public loud and public quiet BPs were slightly different than private quiet 1 BPs, with difference in differences minimal (Table): [Public loud: SBPΔ 0.97 mmHg (95%CI: -0.61, 2.55)/DBPΔ 1.86 mmHg (95%CI: 0.94, 2.78); Public quiet: SBPΔ 1.72mmHg (95%CI: 0.05, 3.39)/DBPΔ 1.66 mmHg (95%CI: 0.79, 2.54)]. The patterns were generally consistent across subgroups by SBP and age. Conclusion: BP readings in noisy public spaces resulted in small overestimation of BP compared to readings in a quiet private office, but the difference was minimal. Large-scale hypertension screening programs in public loud places may be an acceptable option, especially in low resource settings.

Evaluation of a Hospital-based Hypertension Screening Program in Seven Hospitals in Thailand

Evaluation of a Hospital-based Hypertension Screening Program in Seven Hospitals in Thailand

Undiagnosed and Uncontrolled Hypertension and Access to Health Care among Residents of an Urban Area of Eastern Nepal: a Cross-sectional Study

Background The burden and complication of hypertension is increasing as most of the people living with hypertension are unaware of their condition and those who are already diagnosed with it do not have their blood pressure under control.&#x0D; Objective To assess the prevalence of undiagnosed and uncontrolled hypertension among residents of Itahari sub metropolitan city of eastern Nepal, along with its associated socio demographic and behavioral risk factors and access to health care services.&#x0D; Method Cross sectional study was conducted in five wards of Itahari, among 1161 participants, using population proportionate to sample size sampling technique. Face to face interview was conducted with participants for data collection applying semi– structured questionnaire and physical measurement like blood pressure, weight and height.&#x0D; Result Prevalence of hypertension was 26.5% including undiagnosed 11.0% and previously diagnosed 15.5%. Among diagnosed, 76.6% had uncontrolled blood pressure and 56.70% were taking anti-hypertensive medicine, and 7.8% were under Ayurvedic medicine. More than 70% participants preferred private health facility for treatment and 22.7% had faced financial barrier to seek healthcare. About 64% of participants did not visit health services or had visited only once in past six months. Increasing age, Body Mass Index (BMI), smoking status and positive family history were found to be significantly associated with hypertension at &lt; 0.05 level.&#x0D; Conclusion Prevalence of hypertension is high and awareness regarding available health services in local primary health center and its utilization is lacking among participants. Regular screening program for hypertension and awareness program to disseminate the knowledge of availability of primary health center should be conducted.

Abstract MP21: Findings From A Community-based Hypertension Screening Program In Rural Nepal

Introduction: Hypertension is the leading cause of morbidity and mortality in low- and middle-income countries (LMICs). However, data on the prevalence of hypertension in rural areas are limited. Aim: To characterize the prevalence of hypertension in rural areas of Nepal. Methods: Data were collected from two rural municipalities (Rupa and Biruwa) of Nepal as a part of the baseline assessment of quasi-experimental study evaluating whether community-health workers can diagnose and treat hypertension, the MUTU study (NCT 04521582). We surveyed all residents of the municipalities aged 25 to 70 years at their homes during April-July 2021. Three blood pressures (BP) at the home visit were obtained; the average of the last two readings was analyzed. Results: A total of 10,974 adults were screened. Average systolic and diastolic BP (SBP and DBP) were 125.6 (SD 20.3) and 84.2 (SD 11.9) mmHg; 27.7% (n=3,048) had high SBP &gt; 140 and/or DBP &gt; 90 mmHg (‘high BP’). Of all screenees, 13.1% had unrecognized high BP, and 1.7% had BP ≥180/120 mmHg (‘very high BP’). Of those with high BP, 52.8% were aware, 16.9% (n=483) were taking antihypertensive medication, and 6.2% (n=191) had BP ≥180/120 mmHg. Of 2,123 participants with high BP eligible for MUTU (exclusion criteria: BP medication, heart diseases, diabetes, breast-feeding, pregnant, and planned migration), 2,049 participants had BP measured again 1-2 weeks later, and hypertension was confirmed in 1,432 participants (69.9%). See figure. Of these, 5.8% had isolated elevated SBP, and 33.8% isolated elevated DBP; most (60.4%) had elevated SBP and DBP. Conclusions: In this home-based BP screening program conducted in rural Nepal, ~13% of adults aged 25-70 years had unrecognized high BP, including ~2% with BP ≥180/120 mmHg. These results highlight the importance of community-based BP screening as well as the need for effective treatment programs in rural communities

Combining econometric analysis and simulation modeling to evaluate Population-Based health policies for chronic disease prevention and control

ObjectivesPopulation-based health policies play an important role in preventing and controlling chronic disease. Policymakers need to understand both the short- and long-term impacts of different policies to optimize resource allocation. The objective of this study is to develop a framework that combines econometric analysis and simulation modeling for a comprehensive evaluation of population-based health policies. Study designBoth econometric analysis and simulation modeling were used to evaluate the impact of a population-based health policy. MethodsWe identified a cohort of hypertensive patients from the 2011–2013 China Health and Retirement Longitudinal Study and fitted the data into our framework to evaluate the effectiveness of a community-based hypertension-screening program under the Essential Public Health Services (EPHS) policy on the future burden of cardiovascular disease in China. ResultsUsing an econometric approach, we identified that the community-based hypertension screening program would lead to a 7.9% improvement in the rate of hypertension control. Using a validated simulation model, we further estimated that if the policy was fully implemented nationwide, it could avert 97,100 cases of myocardial infarction and 215,600 cases of stroke. The policy would cost $2131 on average to save 1 quality-adjusted life year over 10 years. ConclusionsThis study proposed a framework integrating two different methods and assessing both short- and long-term impact of a population-based health policy. Through a case study, we demonstrated that combining econometric analysis and simulation modeling could provide policymakers with a more powerful tool to evaluate health policies for controlling chronic disease.

Effects of Different Rest Period Durations Prior to Blood Pressure Measurement: The Best Rest Trial.

[Figure: see text].

Targeting Hypertension Screening in Low- and Middle-Income Countries: A Cross-Sectional Analysis of 1.2Million Adults in 56 Countries.

BackgroundAs screening programs in low‐ and middle‐income countries (LMICs) often do not have the resources to screen the entire population, there is frequently a need to target such efforts to easily identifiable priority groups. This study aimed to determine (1) how hypertension prevalence in LMICs varies by age, sex, body mass index, and smoking status, and (2) the ability of different combinations of these variables to accurately predict hypertension.Methods and ResultsWe analyzed individual‐level, nationally representative data from 1 170 629 participants in 56 LMICs, of whom 220 636 (18.8%) had hypertension. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or reporting to be taking blood pressure–lowering medication. The shape of the positive association of hypertension with age and body mass index varied across world regions. We used logistic regression and random forest models to compute the area under the receiver operating characteristic curve in each country for different combinations of age, body mass index, sex, and smoking status. The area under the receiver operating characteristic curve for the model with all 4 predictors ranged from 0.64 to 0.85 between countries, with a country‐level mean of 0.76 across LMICs globally. The mean absolute increase in the area under the receiver operating characteristic curve from the model including only age to the model including all 4 predictors was 0.05.ConclusionsAdding body mass index, sex, and smoking status to age led to only a minor increase in the ability to distinguish between adults with and without hypertension compared with using age alone. Hypertension screening programs in LMICs could use age as the primary variable to target their efforts.

The cost-effectiveness of a two-step blood pressure screening programme in a dental health-care setting.

Hypertension is one of the largest contributors to the disease burden and a major economic challenge for health-care systems. Early detection of persons with high blood pressure can be achieved through screening and has the potential to reduce morbidity and mortality. We evaluate the cost-effectiveness of an opportunistic hypertension screening programme in a dental-care facility for individuals aged 40-75 in comparison to care as usual (the no-screening baseline scenario). A cost-effectiveness analysis (CEA) was carried out from the payer and societal perspectives, and the short-term (from screening until diagnosis has been established) cost per identified case of hypertension and long-term (20 years) cost per quality-adjusted life year (QALY) were reported. Data on the short-term cost were based on a real-world screening programme in which 2025 healthy individuals were screened for hypertension. Data on the long-term cost were based on the short-term outcomes combined with modelling in a Markov cohort model. Deterministic and probabilistic sensitivity analyses were carried out to assess uncertainty. The short-term analysis showed an additional cost of 4,800 SEK (€470) per identified case of hypertension from the payer perspective and from the societal perspective 12,800 SEK (€1,240). The long-term analysis showed a payer cost per QALY of 2.2 million SEK (€210,000) and from the societal perspective 2.8 million SEK per QALY (€270,000). The long-term model results showed that the screening model is unlikely to be cost-effective in a country with a well-developed health-care system and a relatively low prevalence of hypertension.

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.

FEASIBILITY OF HYPERTENSION AWARENESS AND CONTROL IN SWISS PHARMACIES DURING THE MMM17 CAMPAIGN

Abstract Objective: May Measurement Month 2017 was an international screening campaign for hypertension organized by the International Society of Hypertension and the World Hypertension League conducted worldwide on adults over 18 years old. In Switzerland, the campaign was conducted almost exclusively in pharmacies. The objective was to assess the feasibility of a hypertension screening program in pharmacies. Design and method: 40 pharmacies in the Canton of Vaud included participants from the 1st to the 31st May 2017. After obtaining written informed consent, three standardized blood pressure measurements using validated oscillometric devices were taken. A short questionnaire for basic demographic and clinical information was then completed. The BP results and the answers to the aforementioned questionnaire were directly uploaded to a safe data server via on online application. Descriptive statistics and chi-squared tests were used. Results: 1045 participants (73.4% women, p &lt; 0.05) were included in the study. Mean age and body mass index were respectively 48.5 ± 18.7years and 24.5 ± 4.5 kg/m2. The overall prevalence of hypertension was 28.5% using ESH2018 cut-off values for hypertension values and 50.7% using AHA2017 cut-off values. The prevalence was higher in men (42.5 vs 23.5%, p &lt; 0.05 with ESH2018 and 70.5% vs 43.6% with AHA2017). Out of 298 hypertensive participants, 178 were treated and 120 (40.3%) were not treated. Uncontrolled hypertension was present in 36.0% of treated hypertensive participants (no difference between men and women). Systolic blood pressure decreased from the first to the second measurement (124 to 122 mm Hg, p &lt; 0.05) and from the second to the third measurement (122 to 120 mm Hg, p &lt; 0.05). No difference was observed for diastolic blood pressure. Conclusions: Screening program in pharmacies is feasible and enables the identification of untreated or unaware hypertensive patients (13.8%). Women are more likely to participate to hypertension screening programs in pharmacies.

KNOWLEDGE ABOUT ARTERIAL HYPERTENSION IN GENERAL POPULATION: RESULTS OF A COMMUNITY PHARMACY SCREENING PROGRAM

Objective: Hypertension is a cardiovascular and cerebrovascular risk factor. Prevention of hypertension mediated organ damage is a main health problem. Guidelines underlines the importance of screening and educational programs in general population and the role of non-medical sanitary subjects, particularly pharmacists. This study evaluated knowledge about hypertension in a population afferent to community pharmacies of Piedmont and Ligury. Design and method: A questionnaire about knowledge of hypertension has been collected from 2731 community pharmacy costumers, participating to an arterial hypertension screening program. It included three sections about prevalence of hypertension, hypertension-mediated organ damage and preventive lifestyle behaviour. Blood pressure was measured with an Omron HEM 1040-E device. Further information about home blood pressure levels, cardiovascular, metabolic and cerebrovascular comorbidity were collected. Results: 57,5% of subjects were female and mean age was 58,3 ± 15,9 ys. 47% subjects declared a hypertensive status, 41% normotensive one and 12% didn’t know their pressure status. Mean systolic blood pressure was 130 ± 18 mmHg and diastolic blood pressure 79 ± 10 mmHg. 69% of hypertensive subjects was not controlled at pharmacy evaluation, on the base of guidelines office target values. 10% of subjects self-declared normotensive and 35% who didn’t know their blood pressure status had a blood pressure &gt;= 140/90 mmHg. In the questionnaire only 15% of subjects knew hypertension prevalence; 23% had a poor knowledge about lifestyle prevention interventions and 36% have poor knowledge about hypertension mediated organ damage. The proportion of people with poor knowledge was particularly higher in people who didn’t know their pressure status (low level consciousness about lifestyle and consequences in 30% and 48% of subjects respectively). Subjects with a low global knowledge about hypertension had significantly higher blood pressure levels compared to those with a good consciousness. Conclusions: Many people have poor knowledge of hypertension as risk factor; this is the base of poor blood pressure control and non-adherence. Community pharmacies may represent an important resource for education and prevention among general population, including people not seeking medical care.

FRANCE'S PARTICIPATION IN MAY MEASUREMENT MONTH 2019: THE WHOLE STARTING POINT OF A COLLECTIVE WORK WITHIN THE FRENCH SOCIETY OF HYPERTENSION (SFHTA)

Objective: May Measurement Month (MMM) is a global awareness campaign against hypertension launched by the International Society of Hypertension and supported by the World Hypertension League. In France, nearly 1 out of 3 people have hypertension, of which a large proportion remains undiagnosed. The aim of this work is to make data collected during MMM 2019 in France available for the global cohort and raise awareness through this screening action. Design and method: Screening was coordinated by each manager of the 7 different participating sites, while following the standardised MMM protocol. SFHTA (in partnership with Omron France) sponsored centres requesting blood pressure monitors, by offering Omron HEM-FL31/M3 Comfort® devices. Results: Baseline data for 818 subjects (including 66 teenagers) are summarized in joint table. Most participants reported having measured their BP at least once in the past year. 22% measured their BP at least a year ago or never. The number of patient with known hypertension was 208 (25.4%), 176 (21.5%) were treated, out of them 101 (57,4%) were controlled (BP &lt; 140/90 mmHg). In our cohort, 76 healthy subjects (9.2%) had unknown high normal BP and 109 healthy subjects (13.3%) have been screened as new hypertensive patients. Conclusions: Up to day, more than 2.7 million people have taken part in the MMM program worldwide. This first survey in France highlights how a scientific society, such as SFHTA, could beyond education and science also promote a non expensive hypertension screening program to support global awareness and local actions. A wider participation with ancillary studies are planned for 2020 with the need to clarify ethical issues, in order to use national data according to French legislation. Thanks to all patients and the teams at each centre who took part in this campaign.

Factors associated with awareness, treatment and control of hypertension among 3579 hypertensive adults in China: data from the China Health and Nutrition Survey

BackgroundThe prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults.MethodsData collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mmHg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control.ResultsOverall, 3579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR = 2.57; 95%CI, 1.65–4.02), urban residency (1.50; 1.14–1.97), living in the Eastern region (1.52; 1.14–2.01), and being overweight/obese (1.99; 1.39–2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12–1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42–0.76) and minority ethnicity (0.52; 0.31–0.86).ConclusionHypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.

Knowledge on arterial hypertension in general population: Results from a community pharmacy screening program

Backgrounds and aimsHypertension is a risk factor for renal, cardiovascular and cerebrovascular diseases. It is responsible for a large proportion of overall morbidity and mortality every year. Hypertension-mediated organ damage is largely not reversible. For these reasons, prevention has primary importance: sensibilization of population on hypertension-related consequences is essential for therapeutic adherence and reduction of unhealthy lifestyle behaviour. This study aimed to evaluate awareness about hypertension among community pharmacies customers. Methods and resultsA questionnaire about hypertension was collected by 2731 customers from 94 community pharmacies in North West Italy, during a hypertension screening program. Hypertension awareness was unsatisfactory in a large proportion of the sample, with only 15% of subjects having an overall good level of knowledge. Furthermore, lower awareness was associated to higher blood pressure values (132/79 ± 19/11 mmHg vs 128/78 ± 18/10 mmHg, p < 0.001) and subjects resulted hypertensive or uncontrolled despite antihypertensive therapy, presented worse questionnaire scores (4.7 ± 1.9 vs 4.9 ± 2.0, p = 0.03). ConclusionKnowledge about hypertension is largely unsatisfactory among population. Community pharmacies may play as a setting for health education and hypertension screening.

Coverage and effectiveness of hypertension screening in different altitudes of Tibet autonomous region

BackgroundTibet is an autonomous region in China located around an average altitude of 4500 m above sea level. Since 2012 the local government of Tibet has been providing free physical examinations, including screening for hypertension. However, the coverage and effectiveness of this free program have not been uncovered. This study aims to assess the coverage and effectiveness of hypertension screening and management program in 3 altitude levels of Tibet, and also the determinants of the success of the screening program.MethodsA stratified cluster survey was conducted among 1636 residents aged 18 years or over in three different altitude areas in Tibet. We adjusted for age and sex based on national census data and used weighted logistic regression models to find factors associated with hypertension screening.ResultsThe coverage of the hypertension screening program evaluated by participation rate in the previous screening was 94.9%, while 24.7% (95% CI: 22.1–27.3%) of them were diagnosed with hypertension. Females and alcohol drinkers were more likely to be screened. Among those diagnosed with hypertension, 28.7% had it under control. High altitude areas had a high proportion of controlled hypertension. The overall rate of controlled hypertension in high, moderate and low altitude areas was 35.1% (95% CI: 24.8–45.3%), 32.7% (95% CI: 22.2–43.2%) and 23.7% (95% CI: 14.7–32.6%), respectively. Younger aged persons were more likely to have better control of their hypertension.ConclusionsThe coverage of hypertension screening in Tibet was high, especially in the low altitude areas. However, the effectiveness of hypertension control was low, indicating a need to implement the treatment adherence routines into the current screening interventions.