May Measurement Month Research Articles

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

The aim of this study was to highlight the importance of measuring blood pressure (BP) to identify new, known, and treated individuals with hypertension and to raise awareness in the general population about the importance of good BP control. In Paraguay, 3663 individuals aged ≥18 years of both sexes were recruited from May to November 2021 as part of the May Measurement Month (MMM) campaign, which was initiated by the International Society of Hypertension in 2017. Volunteers of 18 regional health teams applied the questionnaire provided by the MMM 2021 organization throughout the country. Due to COVID-19 constraints, the majority of the questionnaires (52.2%) were administered in health centres of the Ministry of Health and concluded with three BP and pulse readings using OMRON-automated BP measurement devices. Hypertension was defined as a systolic BP ≥ 140 mmHg or as a diastolic BP ≥ 90 mmHg or taking antihypertensive medication. We found that 57.4% of screenees were hypertensive and 72.9% of these (82.3% of women and 59.4% of men) had known hypertension. Of patients with hypertension, 70.1% were on antihypertensive medication, and 40.9% had controlled BP (<140/90 mmHg). Among hypertensives detected, 79.7% of women were on antihypertensive medication and 44.1% had controlled BP, while 56.4% of men were on treatment and 34.3% had controlled BP. In summary, we found high levels of hypertension with high rates of awareness and treatment particularly among women, although control rates were low particularly among men. This may be because most screening was conducted predominately in hospital settings.

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

May Measurement Month (MMM) is a global campaign initiated by the International Society of Hypertension (ISH) with the aim of raising awareness of high blood pressure (BP) and serving as a catalyst for the establishment of screening programmes around the world. An opportunistic cross-sectional survey of volunteers aged ≥18 years was conducted. A standardized protocol for MMM was used to measure BP and collect relevant health information from participants at screening sites in four regions of Ghana. Hypertension was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or on antihypertensive medication. A total of 4832 people agreed to take part in the MMM21 study and were screened. After multiple imputation of missing BP readings, 1426 people (29.5%) had hypertension. 11.9% of the 1426 participants with hypertension were aware of their condition, and 8.6% reported taking antihypertensive medication. 24.2% of 123 people on antihypertensive medication had their BP under control (<140/90 mmHg). In addition, only 2.1% of the 1426 participants with hypertension had controlled BP. Results from this study found that almost nine out of 10 people with hypertension who were screened were unaware of their condition, most were untreated, and only 2% of those with hypertension had their BP controlled with medication. This emphasizes the importance of BP screening campaigns as a tool for identifying and referring people with high BP for treatment.

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

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. In Sub-Saharan Africa, hypertension prevalence is higher and cardiovascular events occur at a younger age than in Europe or America. May Measurement Month (MMM) is a global campaign initiated by the International Society of Hypertension (ISH) aimed at raising awareness of high BP. In South Africa, the MMM campaign in 2017, 2018, and 2019 revealed that approximately one-third of adults had hypertension, only half of hypertensives were receiving antihypertensive therapy, and only a third of those with hypertension had controlled BP. These data highlight the need for continued BP screening and awareness campaigns in South Africa. From May to November 2021, a cross-sectional survey of volunteers aged ≥18 years was performed. Blood pressure measurements, definition of hypertension, and statistical analyses followed the MMM protocol. The screening sites targeted the general population mainly on university campuses and pharmacies in preference to hospitals and clinics, aiming to raise awareness and allow access to screening in those less likely to be aware of their BP status. Of the 2294 individuals (age 37.3 ± 16.9 years) screened, 30.8% had hypertension. Of those with hypertension, only 48.6% were aware and 43.5% were receiving treatment for hypertension. A large proportion (50.4%) of individuals receiving antihypertensive medication had uncontrolled BP (≥140/90 mmHg). In conclusion, the high prevalence of hypertension, despite the young adult age, and the high proportions of individuals unaware of their hypertension and with uncontrolled BP underscore the necessity for hypertension awareness campaigns and more rigorous management of hypertension.

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

Hypertension continues to be the leading cause of death and disability in the industrialized world, with a high level of unawareness and unacceptably poor control rates. Therefore, the Argentinian Society of Hypertension, in association with the May Measurement Month (MMM) charity, implemented an awareness campaign during May 2021. A voluntary cross-sectional survey was carried out during the month of May 2021 in public spaces and health centres across 29 cities in Argentina. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg based on the mean of the second and third of three BP measurements or in those volunteers on treatment for high BP. Statistical analysis including multiple imputation followed the MMM protocol. A total of 26 070 individuals (average age 53.4 years, 14 816 women and 11 254 men) were evaluated. The age- and sex-standardized mean BP was 125.1/77.6 mmHg. Of all participants, 54.4% had hypertension. Although 79.8% of the hypertensive participants were aware of their condition and 76.9% were on antihypertensive treatment, only 42.5% of all individuals with hypertension had their BP controlled (<140/90 mmHg). Of those on antihypertensive medication, 55.3% were controlled. The low level of hypertension control highlights the critical need for community-based prevention strategies to increase the awareness and control of hypertension, thereby reducing the enormous health burden attributed to this condition.

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.

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

Elevated blood pressure (BP) is a growing burden worldwide and is the leading cause of mortality and disability-adjusted life years all over the world. May Measurement Month (MMM) is a global initiative aimed to increase awareness of high BP initiated by the International Society of Hypertension, to identify individuals in need of improved hypertension care, and to improve BP screening worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in accordance with standard MMM protocol in 2021. The study was conducted in public areas, both indoor and outdoor, as well as in primary and secondary healthcare centres. A total of 5777 individuals (mean age 51.8 ± 16.1 years, 49.8% female) were screened. After imputation, 45.7% participants had hypertension and 43.7% of them were aware of their high BP. Of 2640 participants with hypertension, 887 (33.6%) were on antihypertensive treatment, of whom 32.4% were on single medication, 29.7% on two medications, and 37.9% on three or more. Only 42.2% of those on medication had controlled BP (<140/90 mmHg), whereas of the participants with hypertension overall, 14.2% had controlled BP. We found that the prevalence of inadequately treated hypertension remains high in Armenia and may represent a vital contributor to the growing burden of non-communicable diseases.

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

May Measurement Month (MMM) is a global and national blood pressure (BP) screening campaign initiated by the International Society of Hypertension to improve awareness of BP worldwide. This study reports on the findings of the MMM21 campaign in Australia. Adult participants (≥18 years) were screened through opportunistic sampling across Australia between 1 May and 30 November 2021. Trained volunteers recorded standardized BP measurements from community volunteer participants along with demographic data, lifestyle factors, comorbidities, and history of COVID-19 infection and vaccination. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg and/or taking antihypertensive medication. Data were collated and analysed centrally using the current MMM protocol and presented after the imputation of missing BP readings. A total of 1307 participants were screened in 2021, comprising 652 (49.9%) females and 654 (50.0%) males with a mean age of 48 years (SD 20.1). Of all 1307 participants, 524 (40.1%) had hypertension. Of participants with hypertension, 65.4% were aware and 59.3% were on antihypertensive medication. Of 311 participants on antihypertensive medication, 54.7% had controlled BP. Of all 524 participants with hypertension, 32.5% had controlled BP. The current 2021 data may indicate some progress in creating BP awareness; however, consecutive Australian data obtained since 2017 demonstrated stagnating treatment, and control rates compared with global rates and those in other high-income countries. Concerted efforts from all stakeholders will be required to further improve BP awareness, treatment, and control rates in Australia.

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

Cardiovascular disease is not only the leading cause of mortality in Bulgaria, but the associated mortality rate is twice the European Union average, so screening programmes that identify subjects with elevated blood pressure (BP) are of utmost importance. May Measurement Month (MMM) is an annual global initiative that began in 2017 that aims to raise awareness of high BP. Bulgaria first joined the third campaign of MMM in 2019, and an overview of the results of Bulgarian participation in MMM21 is presented in this paper. Hypertension was defined as receiving BP-lowering medications or having a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Statistical analysis followed the standard MMM protocol. In Bulgaria, 155 screening sites were set up in primary and secondary care facilities, in pharmacies, and outdoor spaces across 16 administrative districts. Out of 3908 individuals screened, 2896 participants (74.1%) had hypertension. Of 2896 participants with hypertension, 76.4% were on treatment of whom 48.5% had controlled BP (<140/90 mmHg). Out of 1696 participants not on antihypertensive medication, 684 (40.3%) had elevated BP. Men were found to have higher rates of undiagnosed hypertension and lower rates of control than women. By identifying almost two-thirds of the whole screened cohort with the possibility of newly diagnosed or uncontrolled hypertension, our results confirm the importance of BP screening.

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

Previous studies have shown that among Bangladeshi adults, one-fifth have hypertension. The National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) campaigns in 2017, 2018, 2019, as well as in 2021 as a part of a global initiative aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of nationwide screening programmes. This opportunistic screening of voluntary participants aged ≥18 years was carried out from May to July 2021. Data were collected from more than 150 screening sites in all 64 districts in Bangladesh. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Data on 28 355 individuals were finally analysed. Among the participants, 17 941 (63.3%) were female. After multiple imputation, 11 194 (39.5%) had hypertension. Among the 11 194 participants with hypertension, 78.8% were aware of having hypertension and 65.6% were on antihypertensive medication. Among 11 194 participants with hypertension, 7340 participants (65.6%) were on antihypertensive medication and 43.8% had controlled BP (<140/90 mmHg). Of those on antihypertensive medication, 66.8% had controlled BP. A voluntary BP screening programme can identify significant numbers of people with raised BP and thus contributes importantly to the prevention of cardiovascular diseases.

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.

COMMUNITY PHARMACY-BASED HYPERTENSION SCREENING: MAY MEASUREMENT MONTH 2023 IN 3 CANADIAN PROVINCES

Objective: Elevated blood pressure (BP) is the largest contributing risk factor for premature death and disability. Approximately 50% of individuals with hypertension are unaware they have the condition; therefore, BP screening is essential. Canadian health professionals have previously participated in the annual global BP screening campaign, May Measurement Month (MMM); however this has never been completed in community pharmacies, which have the advantage of being highly accessible to the public. Our objective was to examine the prevalence of elevated (BP) in Alberta (AB), British Columbia (BC), Newfoundland and Labrador (NL) during MMM 2023. Design and method: This cross-sectional study enrolled consenting members of the general public 18 years of age, recruited through signage, media and social media. Data collection took place between May 1 and July 31, 2023 in 52 community pharmacies across AB, BC, and NL. Participants completed a questionnaire that included demographic information, medical history, and use of antihypertensives. Pharmacy personnel completed 3 blood pressure readings, with readings 2 and 3 used to estimate BP. We used an automated blood pressure device recommended by Hypertension Canada's Device Recommendation Program. Elevated BP was defined as &gt;140/90mmHg or &gt;130/80mmHg for individuals with diabetes. Results: We enrolled 736 participants. The mean age of participants was 52 (SD 18.6) years, 66% were female, 34% had a history of hypertension, and 14% had diabetes. Overall, 21% (152/733) had elevated BP. In subgroups of interest, elevated BP was found in 20% (96/480) of females, 35% (88/251) of those with a history of hypertension (13% (64/482) in those with no history of hypertension), and 52% (53/103) in those with diabetes. Conclusions: Identifying individuals with elevated BP is the starting point for better BP management. Community pharmacy screening of BP was effective in identifying individuals with elevated BP warranting further assessment. Our experiences from MMM 2023 will guide the future scale-up of a national community pharmacy-based screening program for MMM 2024.

BLOOD PRESSURE VARIABILITY AND HISTORY OF CARDIOVASCULAR EVENTS IN MAY MEASUREMENT MONTH 2019 PARTICIPANTS

Objective: Increased blood pressure variability (BPV) is associated with negative health outcomes, but its determinants, and how best to measure it, remain unclear. We aimed to explore differences in four commonly used measures of BPV by clinical factors in the May Measurement Month (MMM) 2019 global survey. Design and method: We performed an observational analysis of BP readings from MMM 2019 survey participants. Volunteer adult (18 years or older) participants were surveyed via convenience sampling from 92 countries in May 2019. Each participant had three seated BP readings. Four indices of diastolic and systolic BPV were calculated for participants with all three BP readings: the standard deviation (SD), coefficient of variation (CV), absolute difference between the second and first BP readings (AR), and the variation independent of the mean (VIM). Factors examined included use of antihypertensive medication, being obese (body mass index greater than 29 kg/m2), and having a diagnosis of diabetes, myocardial infarction, or stroke. For each BPV index and factor, a regression model was created with the index as the outcome. Each model was adjusted for mean BP (based on the average of the second and third BP readings), age, sex, an interaction between age and sex, and antihypertensive medication use. Age and mean BP were each included as natural cubic splines with five knots. Results: Data from for 1,133,008 (75.1%) participants were included. The mean age was 45.6 (SD 16.6) and 52.0% were female. Coefficient estimates were similar for SD, VIM, and CV (Figure 1). Lower systolic and diastolic BPV were seen in participants who reported use of antihypertensive medication, and in those with a previous history of stroke, diabetes, or MI. There were small but statistically significant differences by obesity status. Conclusions: Diabetes, a history of myocardial infarction or stroke and the use of antihypertensive medication were associated with lower within-visit BPV, independent of age or sex. This may reflect underlying physiological differences between groups or differences in BPV-lowering effects resulting from different lifestyle choices or medication usage of these participants.

NON-LINEAR RELATIONSHIPS BETWEEN WITHIN-VISIT BLOOD PRESSURE VARIABILITY, MEAN BLOOD PRESSURE, SEX, AND AGE IN UNTREATED MAY MEASURMENT MONTH 2019 PARTICIPANTS

Objective: This study aimed to explore change in four commonly used measures of blood pressure variability (BPV) by mean blood pressure (BP), age, and sex in May Measurement Month (MMM) 2019 global survey participants. Design and method: We performed an observational analysis of BP readings from MMM 2019 participants. Adults (18 years and older) were surveyed via convenience sampling from 92 countries in May 2019. Each participant had three seated BP readings. Participants who reported taking antihypertensive medication or who lacked all three readings were excluded. Four indices of BPV were calculated: the standard deviation (SD), coefficient of variation (CV), absolute difference between the second and first BP readings (AR), and variation independent of the mean (VIM). A regression model was created for each index. Each model was adjusted for mean BP, age, sex, and an interaction between age and sex. Age and mean BP were each included as natural cubic splines with five knots. Results: Data from 922,259 participants were included. The mean age was 42.6 (SD 15.9) and 50.8% were female. Systolic SD and AR increased with higher mean BP up to 150 mmHg, while systolic CV and VIM decreased with higher BP across the BP range (Figure 1). Up to 90 mmHg, diastolic CV and VIM decreased with increased mean BP. All diastolic indices increased with higher mean BP above 90 mmHg. Systolic BPV was higher in females between 35 and 70 years (Figure 2), with little difference between sexes within diastolic BPV. Diastolic BPV was lowest between 40 and 50 years of age and highest in the youngest and oldest age groups. Systolic BPV was lowest between 25 and 30 years for females, and at around 45 years for males. Conclusions: All within-visit BPV indices examined showed non-linear variation with mean BP levels and age, particularly for diastolic BPV. Studies should consider non-linear effects when investigating and modelling BPV.

PREVALENCE, AWARENESS AND THERAPEUTIC CONTROL OF HYPERTENSION IN BELGIUM: AN OPPORTUNISTIC SCREENING OF NEARLY 6,000 PARTICIPANTS DURING THE MAY MEASUREMENT MONTH CAMPAIGNS 2017-23

Objective: The May Measurement Month (MMM) initiative is an annual global screening and awareness campaign started in 2017 by the International Society of Hypertension highlighting the importance of regular measurements of blood pressure (BP), the most important modifiable risk factor contributing to cardiovascular and all-cause mortality worldwide. Here we report on the results of the MMM campaign done in Belgium during the month of May in 2017, 2018, 2019, 2022 and 2023. Design and method: Participants 18 years or older were recruited through opportunistic sampling in 12 sites (mostly hospital entrances) across Belgium. Apart from standardized BP recordings (OMRON automated devices) by trained staff, data were collected on demographics, lifestyle factors and comorbidities. Hypertension was defined as raised blood pressure (systolic BP =&gt;140 mmHg and/or diastolic BP =&gt; 90 mmHg) and/or taking antihypertensive medication. Age-standardized prevalence rates were calculated using the overall Belgian population (1st Jan 2023) as reference. Results: Data were collected from 5,926 participants aged 51.5 years on average. Mean (SD) systolic and diastolic blood pressures were 125.9 (17.6) mmHg and 79.4 (10.9) mmHg with 26.7% exceeding the 140/90 mmHg threshold. Age-standardized prevalences (95% CI) of hypertension were 45.4% (42.6%-48.1%) in men and 36.9% (34.8%-39.0%) in women. Among the 2,468 individuals with hypertension, 1,938 (78.5%) had been previously diagnosed and 1,578 (81.4%) of those with known hypertension, received antihypertensive treatment. Only about half of those being treated (56.3%) did achieve the target of systolic/diastolic BP &lt;140/90 mmHg. Inadequate therapeutic control was independently associated with increasing age and higher body mass index. Untreated hypertension was significantly associated with male sex, age, body mass index and alcohol use. Conclusions: Despite the potential limited representativeness of the sample, these data suggest that the ‘rule of halves’ for hypertension does not longer hold in Belgium and that therapeutic control of hypertension is still suboptimal.

Clinical and treatment profiles of arterial hypertension in Mexico during the COVID-19 pandemic: a cross-sectional survey endorsed by the "Collaborative Group on Arterial Hypertension".

Arterial hypertension is highly prevalent in Mexico; nevertheless, there are limited insights regarding its management during the COVID-19 pandemic. Here, we estimate the prevalence of clinical and treatment profiles of arterial hypertension and explore associated factors for undiagnosed and uncontrolled hypertension using a cross-sectional survey endorsed by the Collaborative Group on Arterial Hypertension from the Mexican Institute of Social Security. Our survey was conducted from May to November 2021 using the May-Measurement Month 2021 protocols of the International Society of Hypertension. Arterial hypertension (defined as: blood pressure [BP] ≥140/90 mmHg, previous diagnosis, or taking antihypertensives) and its clinical and treatment profiles were classified according to the World Hypertension League Expert Committee. Mixed-effects logistic regression models were used to explore associated factors for undiagnosed and uncontrolled hypertension. Among 77,145 screened participants (women: 62.4%; median age: 46 [IQR: 32-59] years), the prevalence of arterial hypertension was 35.7% (95% CI: 35.3-36.0, n = 27,540). Among participants with arterial hypertension, 30.9% (95% CI: 30.4-31.5, n = 8,533) were undiagnosed, 6.6% (95% CI: 6.3%-6.9%, n = 1,806) were diagnosed but untreated, 43.4% (95% CI: 42.9-44.0, n = 11,965) had uncontrolled hypertension, and only 19% (95% CI: 18.6%-19.5%, n = 5,236) achieved hypertension control (BP < 130/80 mmHg). Explored associated factors for undiagnosed and uncontrolled hypertension include being men, living in the central and southern regions, lower educational attainments, higher use of pharmacological agents, and previous COVID-19 infection. Our findings suggest that adverse arterial hypertension profiles, mainly undiagnosed and uncontrolled hypertension, were highly prevalent during the context of the COVID-19 pandemic in Mexico.

High prevalence but lack of awareness of hypertension in South Africa, particularly among men and young adults.

Cardiovascular disease (CVD) is a leading cause of death in South Africa (SA) and high blood pressure (BP) is the primary risk factor. However, hypertension prevalence is high, BP control is poor and CV events occur at a younger age than in Europe or America. Increasing screening, raising awareness and improving management of hypertension are critical to prevent CVD in SA. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension aimed at raising awareness of high BP. As part of the MMM campaign, in SA (2017, 2018, 2019 and 2021), BP measurements and a cross-sectional survey of volunteers aged ≥ 18years were performed. Of 11,320 individuals (age 36.6 ± 16.8years) screened, 29.7% had hypertension (systolic BP/diastolic BP ≥ 140/90 mmHg or antihypertensive medication use) and the prevalence was higher (p < 0.0001) in men (35.6%) than in women (26.3%). Of those with hypertension, only 54.3% were aware and 46.8% were receiving antihypertensive medication, and 53.7% of these had controlled BP. In men with hypertension, awareness (45.2%, treatment (38.2%) and controlled BP on antihypertensive medication (45.2%) were lower (p < 0.0001) than in women (awareness: 60.8%; treatment: 53.5%; controlled BP: 58.3%). In young participants (age < 40years), 15.6% had hypertension, 18.6% of these were on treatment but 76.0% were not aware, and only 57.7% had controlled BP. The high prevalence of hypertension, but low levels of awareness, treatment, and BP control in SA, especially in young adults and men, highlight the need for systematic BP screening programmes and improvements in education and management of hypertension.

May Measurement Month 2019: Screening Analysis In Spanish Community Pharmacies and Detection of Masked Hypertension

To know within the scope of the May Measurement Month (MMM) project, the blood pressure (BP) situation in the Spanish population, disseminate the importance of its periodic measurement and estimate the prevalence of masked hypertension (MH). Transversal descriptive study in Spanish community pharmacies during May 2019. Systolic blood pressure (SBP), diastolic blood pressure (DBP) in millimetres of mercury (mmHg), heart rate (HR) in beats per minute (bpm).Subjects with BP ≥130/85 and <149/90 were offered the possibility of home blood pressure monitor- ing (HBPM) to confirm MH. A total of 3402 valid records performed by 491 pharmacists. In all 61.9% women, mean age 56.6 years. A total of 143 (4.2%) had never measured BP and 918 (27.0%) had not measured BP in the last year; 1047 were taking anti-hypertensives, of whom 45.7% had high BP.A total of 780 (22.9%) subjects had high BP values; both, 252 (7.4%). mSBP and mDBP was 125.0 mmHg and 76.5 mmHg, respectively; higher in men (P<0.001). mHR was 72.6 bpm..A direct relationship was detected between SBP and DBP and BMI (P<0.0001). mSBP and mHR were higher in smokers (P<0.0001). In diabetic patients, SBP, DBP and HR were greater.A total of 61 subjects with suspected MH agreed to undergo HBPM. A total of 25 (40.1%) resulted in BP ≥135/85 mmHg. Almost a quarter of subjects had BP ≥140/90 mmHg. The risk factors most closely related to high BP were overweight, diabetes and age; 40% of suspected cases of MH were confirmed by means of HBPM.

Opportunistic screening for hypertension in the general population in Bulgaria: international society of hypertension may measurement month campaign

Cardiovascular diseases are not only the leading causes of mortality in Bulgaria but also the mortality rate is twice as high as the European Union average, so screening programmes identifying subjects with elevated blood pressure (BP) are of utmost importance. May Measurement Month (MMM) is an annual global initiative of the International Society of hypertension that began in 2017 aimed at raising awareness of high BP. Bulgaria joined the 3rd campaign of MMM in 2019 and an overview of the results of Bulgarian participation are presented in this paper. Hypertension was defined as systolic BP &amp;ge; 140 mm Hg and diastolic BP &amp;ge; 90 mm Hg or treatment for hypertension, statistical analysis followed the standard MMM protocol. In Bulgaria, 150 screening points were set up in primary and secondary care facilities, in pharmacies, and outdoor spaces across 21 administrative districts. Out of 3678 individuals screened, 2587 participants (70.3%) had hypertension. Of 2896 participants with hypertension, 35.6% had controlled BP. Out of 1760 participants not on antihypertensive medication, 669 (38%) had elevated BP. In the case of treated individuals (n = 1918), 997 (52%) had uncontrolled hypertension. In the untreated cohort, every 4th subject had elevated BP, whilst among patients on antihypertensive medication, every second had uncontrolled BP, the worst results in terms of diagnosis and treatment are observed in men. By identifying almost two-third of the whole screened cohort with the possibility of newly diagnosed or uncontrolled hypertension, our results confirm the importance of BP screening campaigns.

Global blood pressure screening during the COVID-19 pandemic: results from the May Measurement Month 2021 campaign.

Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic. Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and clinical data. Hypertension was defined as a systolic BP at least 140 mmHg and/or a diastolic BP at least 90 mmHg (using the mean of the second and third readings) or taking antihypertensive medication. Multiple imputation was used to impute the average BP when readings were missing. Of the 642 057 screenees, 225 882 (35.2%) were classified as hypertensive, of whom 56.8% were aware, and 50.3% were on antihypertensive medication. Of those on treatment, 53.9% had controlled BP (<140/90 mmHg). Awareness, treatment and control rates were lower than those reported in MMM campaigns before the COVID-19 pandemic. Minimal changes were apparent among those testing positive for, or being vaccinated against COVID-19. Of those on antihypertensive medication, 94.7% reported no change in their treatment because of the COVID-19 pandemic. The high yield of untreated or inadequately treated hypertension in MMM 2021 confirms the need for systematic BP screening where it does not currently exist.