Publications
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Nadar SK, Al-Riyami H, Al-Riyami A, et al., 2020, May measurement month: data from a national screening programme in Oman in 2017 and 2018, Publisher: SPRINGERNATURE, ISSN: 0950-9240
Beaney T, Schutte AE, Stergiou GS, et al., 2020, May Measurement Month 2019 The Global Blood Pressure Screening Campaign of the International Society of Hypertension, Hypertension, Vol: 76, Pages: 333-341, ISSN: 0194-911X
Elevated blood pressure remains the single biggest risk factor contributing to the global burden of disease and mortality. May Measurement Month is an annual global screening campaign aiming to improve awareness of blood pressure at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at sites in 92 countries during May 2019. Ideally, 3 blood pressure readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg (mean of the second and third readings) or taking antihypertensive medication. When necessary, multiple imputation was used to estimate participants’ mean blood pressure. Mixed-effects models were used to evaluate associations between blood pressure and participant characteristics. Of 1 508 130 screenees 482 273 (32.0%) had never had a blood pressure measurement before and 513 337 (34.0%) had hypertension, of whom 58.7% were aware, and 54.7% were on antihypertensive medication. Of those on medication, 57.8% were controlled to <140/90 mm Hg, and 28.9% to <130/80 mm Hg. Of all those with hypertension, 31.7% were controlled to <140/90 mm Hg, and 350 825 (23.3%) participants had untreated or inadequately treated hypertension. Of those taking antihypertensive medication, half were taking only a single drug, and 25% reported using aspirin inappropriately. This survey is the largest ever synchronized and standardized contemporary compilation of global blood pressure data. This campaign is needed as a temporary substitute for systematic blood pressure screening in many countries worldwide.
Castillo RR, Mercado-Asis LB, Atilano AA, et al., 2020, May measurement month 2018: an analysis of blood pressure screening in the Philippines., European Heart Journal Supplements, Vol: 22, Pages: H104-H107, ISSN: 1520-765X
Building on the gains of May Measurement Month 2017 (MMM17), the Philippine Society of Hypertension once again took part in MMM18 to raise awareness of high blood pressure (BP) in the country and to harness opportunistic BP screening in detecting unaware hypertensive individuals and referring them for treatment. We followed the standard MMM18 protocol designed by the International Society of Hypertension, utilizing convenience sampling with volunteer investigators, taking three sitting BP measurements of volunteer adults (≥18 years). Basic data on demographic, lifestyle, and environmental factors were also taken. We analysed 177 176 screened individuals from the Philippines. Of these, 29.1% (51 527) had also participated in MMM17, whereas 68.8% (121 893) were new screenees; and 14.2% (25 232) had their BP taken for the first time ever. After multiple imputation, 39.0% (69 126) were hypertensive. Of these, 50.3% (34 795) were aware they were hypertensive. 49.9% (34 491) were on antihypertensive medication, 58.0% (20 010) of whom had controlled BP <140/90 mmHg. Only 28.9% of all participants with hypertension had controlled BP. Systolic BPs and diastolic BPs were significantly higher in the overweight and obese, in those receiving antihypertensive medications, in patients with diabetes, and significantly lower in pregnant women. MMM18 has again shown that opportunistic BP screening, harnessing volunteers, is a pragmatic public health measure to improve awareness and treatment rates of raised BP.
Burazeri G, Qirjako G, Beaney T, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Albania., European Heart Journal Supplements, Vol: 22, Pages: H5-H7, ISSN: 1520-765X
This article reports on May Measurement Month (MMM) 2018, which consisted of the 2nd round of the hypertension screening campaign conducted in Albania, a former communist country in South Eastern Europe. The hypertension screening campaign in Albania was conducted during the period 13-31 May 2018. Overall, there were eight sites from seven districts of the country involving 7046 participants aged ≥18 years (61% women and 39% men; overall mean age 46.8 ± 15.7 years). Blood pressure was measured with OMRON sphygmomanometers (Omron Healthcare, Kyoto, Japan). Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg, or on treatment for hypertension. Self-reported information included height and weight, diabetes, smoking status, and alcohol intake. The proportion of participants with hypertension was 37.2% of whom only 52.1% exhibited awareness. Furthermore, only a quarter of hypertensive individuals were properly treated and controlled. Significant predictors of high SBP and/or high DBP included a previous diagnosis of hypertension, being on antihypertensive medication, frequent alcohol intake, and being overweight and obese. The MMM 2018 campaign in Albania had a unique value for early detection of hypertension, particularly among younger adults. Policymakers and decision-makers in Albania and elsewhere should also rely on the MMM screening campaigns which have a great potential for prevention and control of hypertension in the general population.
Victória Pereira S, Neto M, Feijão A, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Angola., European Heart Journal Supplements, Vol: 22, Pages: H8-H10, ISSN: 1520-765X
Elevated blood pressure (BP) is a growing burden worldwide with high prevalence in the world and with a huge impact on public health. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. In Angola 14 433 individuals (mean age 38.6 years; 53.7% female; 99.9% black) in 6 of 18 provinces were screened. In total, 99.0% of screenees provided three BP readings with an average BP from 2nd and 3rd reading of 126/80 mmHg. After imputation, 4844 (33.6%) had hypertension of whom 54.2% were aware of their diagnosis and 46.3% were on antihypertensive medication. Of those medicated, 42.6% were controlled and of all hypertensive individuals, 19.7% were controlled. We screened 2603 individuals with untreated hypertension and 1285 with inadequately treated hypertension. Angolan MMM18 emerges as a continuation of the Angolan MMM17 study, the largest BP screening campaign undertaken in Angola, enabling us to compare the 2 years. This year's results also showed a high percentage of hypertensive individuals and almost 3900 adults with untreated or inadequately treated hypertension, demonstrating that there is still a long way to go but also that the Angolan MMM is being effective at raising awareness at least among these individuals.
Espeche WG, Rojas C, Stisman D, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Argentinean cohort., European Heart Journal Supplements, Vol: 22, Pages: H11-H13, ISSN: 1520-765X
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. Therefore, the Argentinian Society of Hypertension, in agreement with the May Measurement Month (MMM) initiative of the International Society of Hypertension, implemented for the second consecutive year an educational campaign during the month of May 2018. A volunteer cross-sectional survey was carried out in public spaces and health centres during the month of May 2018 across 33 cities in Argentina. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg based on the mean of the 2nd and 3rd of three consecutive BP measurements, or in those on treatment for high BP. Statistical analysis including multiple imputation followed the MMM protocol. A total of 70 418 individuals were screened during MMM18, after excluding those under 18 years old. Of the total, 43.8% of participants were classified as hypertensive, 77.7% were aware of their diagnosis, 69.1% were on pharmacological treatment, and 38.7% were controlled. Of those on antihypertensive medication, 56.0% were controlled. It is necessary to reinforce strategies not only to increase the awareness and control of hypertension but also to identify the population groups, in which these strategies would have the greatest impact, helping to reduce the enormous health burden attributed to hypertension.
Zelveian P, Avagyan A, Minasyan A, et al., 2020, An analysis of blood pressure screening of 21 112 participants in Armenia: May Measurement Month 2018., European Heart Journal Supplements, Vol: 22, Pages: H14-H16, ISSN: 1520-765X
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 raise awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May to July 2018. Blood pressure measurement, the definition of hypertension (HTN) and statistical analysis followed the standard MMM protocol. The study was conducted in public areas (17 sites in Yerevan and 22 in regions), both indoor and outdoor, as well as in 78 primary care centres. A total of 21 112 individuals were screened during MMM18, of which 20 732 had three BP measurements available. The mean age of screened individuals was 46.2 ± 17.3 years, 57.8% were female. At the time of screening, 26.1% were on antihypertensive medication. After imputation, the percentage of participants with HTN was 38.7%, and 76.7% of them were aware of their high BP. Of participants receiving treatment, 47.1% had a controlled BP. MMM18 was the largest BP screening campaign undertaken in Armenia. We found that the proportion of HTN is substantial in Armenia, which may be a vital contributor to the growing burden of non-communicable diseases. Our results also suggest that untreated HTN is common and when treated still not adequately controlled in Armenia. The current situation, with an insufficient control rate of HTN, must be changed as soon as possible.
Carnagarin R, Fonseca R, Brockman D, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Australia., European Heart Journal Supplements, Vol: 22, Pages: H17-H19, ISSN: 1520-765X
May Measurement Month (MMM), originally initiated as a temporary solution to address the lack of blood pressure (BP) screening programs worldwide, emerged as an effective annual campaign to increase the awareness of hypertension. MMM18, a cross-sectional survey of volunteers aged ≥18 years was carried out during May 2018 predominantly in capital cities across Australia following the standard MMM protocol. Blood pressure screening along with additional information including anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors were collected from 3 352 individuals across Australia. After multiple imputation, 1 026 (30.6%) adult Australians had hypertension. Of the 2 936 individuals not on antihypertensive treatment, 610 (20.8%) were hypertensive, and 237 (57.1%) of the 416 individuals receiving antihypertensive treatment had uncontrolled BP. In line with MMM17 results and other previous surveys, MMM18 revealed that close to one-third of the screened population (30.6%) had hypertension, 57.1% of individuals treated with BP-lowering medication remained uncontrolled indicating suboptimal management of the condition in the majority of patients. Most importantly, only 49.0% of those with hypertension were aware of their elevated BP, highlighting lack of awareness of elevated BP in nearly half of the affected population. Elevated BP was directly associated with alcohol consumption, overweight, and obesity. Our findings demonstrate the need for (i) continued efforts to increase BP awareness in the population, (ii) optimization of BP management strategies, and (iii) tackling some of the major contributors to BP elevation, including alcohol consumption and obesity.
Malik F-T-N, Al Mamun MA, Ishraquzzaman M, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Bangladesh., European Heart Journal Supplements, Vol: 22, Pages: H20-H22, ISSN: 1520-765X
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. According to Non-communicable disease (NCD) Risk Factors Survey Bangladesh 2010, one-fifth (21.9%) of adults aged 25 years or more have hypertension. Almost one-third of the adult population did not have their BP measured in their lifetime in Bangladesh. National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2018 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes nationally. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the MMM protocol. Data were collected from 10 screening sites in 9 districts in Bangladesh. A total of 5208 individuals were screened during MMM18. After multiple imputation, 1750 (33.6%) had hypertension. Among the 1750 participants with hypertension, 1312 (75.0%) were aware of having hypertension. Among those that were not on antihypertensive medication, 15.2% were hypertensive and among those that were on antihypertensive medication 33.6% had uncontrolled hypertension. The present study showed that opportunistic screening can identify significant numbers of people with raised BP. A periodic public health programme at a national level needs to be initiated to increase hypertension detection and control rates and thus for prevention of cardiovascular diseases.
Masupe T, Tlhakanelo JT, Tiro MB, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Botswana., European Heart Journal Supplements, Vol: 22, Pages: H23-H25, ISSN: 1520-765X
During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure (BP) across different communities in Botswana. Study sites included four large villages and Gaborone (capital city). Screening sites were shopping malls, train stations, churches, and workplaces. Individuals aged ≥18 years were recruited through fliers, word of mouth, and as volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three BP readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used and was estimated using multiple imputation where missing. Amongst 4599 participants whose BPs were measured, 54.5% were female, while mean age was 35.9 years. A total of 1510 (32.8%) participants were hypertensive and of those, 712 (47.1%) were aware of the hypertension. Only 35.2% of hypertensives were on antihypertensive treatment with 54.4% had controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Risk factors associated with higher BP included obesity, more than 1 unit of alcohol/week and BP measured on Sunday. Less than half (47.1%) of those identified as having hypertension during MMM18 were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
Azevedo V, Dias L, Soares I, et al., 2020, May measurement month 2018: an analyses of blood pressure screening results from Cabo Verde., European Heart Journal Supplements, Vol: 22, Pages: H30-H32, ISSN: 1520-765X
Raised blood pressure (BP) is the biggest contributor to mortality and disease burden in Cabo Verde. May Measurement Month (MMM) is a global campaign set up in 2017 to raise awareness of high BP. In 2018, we aimed to expand the campaign by including a greater number of centres to increase awareness. Nine islands participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 98.0% of screenees provided three BP readings and multiple imputation using chained equations was used to impute missing readings. A total of 8008 individuals (mean age 40.4 years; 68.5% female) were screened. After multiple imputation, 2666 (33.3%) individuals had hypertension, of whom 74.8% were aware of their previous diagnosis and 55.8% were taking antihypertensive medication. Of those on medication, 39.1% were controlled and of all hypertensives, 21.8% were controlled. We detected 44.2% of individuals with untreated hypertension and 60.9% of treated individuals were inadequately treated. The Cape Verdean population is ageing and consequently cardiovascular disease is increasing, with hypertension being an important risk factor. Corrective actions need to be taken by the government. MMM is an ideal initiative to reach the public by raising awareness of this major cardiovascular risk factor.
Barbosa E, Eibel B, Feitosa ADM, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Brazil., European Heart Journal Supplements, Vol: 22, Pages: H26-H29, ISSN: 1520-765X
Hypertension is a pathology of high prevalence in the world. In Brazil, it is the main risk factor for the major cause of death in the country, coronary heart disease. The May Measurement Month Campaign in 2018 (MMM18) included a population with representation from all Brazilian states and reflects some of the characteristics of hypertension in Brazil. Questionnaire data were collected and three measures of blood pressure (BP) were performed. The sample consisted of 12 413 individuals, 59.1% were white, 51.3% were women. The average age was 54. ± 16.0 years. Diabetes was present in 11.6%, previous myocardial infarction in 5.9%, and previous stroke in 2.7%. Current smokers were 9.3% and 12.4% were regular drinkers. The average body mass index was 27.3 ± 4.5 kg/m2. After multiple imputations, 67.9% were hypertensive (>140/90 mmHg). Of the individuals who were not taking antihypertensive medication, 27.9% were hypertensive and of those taking antihypertensive medication, 40.3% were uncontrolled. Systolic BP increased with age. The MMM18 campaign demonstrated a large number of unknown hypertensives and a high rate of uncontrolled hypertension in Brazil, unfortunately in keeping with 2017 findings.
Dzudie A, Njume E, Boombhi J, et al., 2020, May measurement month 2018: blood pressure screening results in Cameroon., European Heart Journal Supplements, Vol: 22, Pages: H33-H36, ISSN: 1520-765X
Hypertension is a global public health challenge, but awareness, treatment, and control rates remain low. May Measurement Month (MMM) creates a platform for awareness creation and opportunistic screening which can identify significant numbers with raised blood pressure (BP). We present results of the 2018 edition of MMM in Cameroon. A cross-sectional survey of self-selected volunteers aged ≥18 years was conducted in May 2018. The definition of hypertension and statistical analyses followed the standard protocol. Data were collected from 28 public (indoors and outdoors) and private locations which were assigned unique site identification numbers, over a 30-day period. Of the 8883 participants screened, 53.8% were male and the median age was 35 (interquartile range 21) years, and 30.0% reported not having a previous BP measurement. After imputation, 1867 (21.0%) were hypertensive, 645 (34.5%) were aware of their diagnosis, and 507 (27.2%) were on antihypertensive medication, among whom 242 (47.8%) had controlled BP. In linear regression models adjusting for age, sex, and the use of antihypertensive medication, systolic and diastolic BP were significantly higher in participants aware of their diagnosis, those on antihypertensive medication, and who reported alcohol intake of 1-3 times per month and, one or more times per week. Hypertension prevalence is the lowest, and awareness, treatments, and control rates the highest reported in epidemiological studies in Cameroon in the last two decades. Further surveys will be useful in evaluating the impact, if any, of the MMM campaign on the burden of hypertension in the Cameroon.
Lanas F, Garcia MS, Paccot M, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Chile., European Heart Journal Supplements, Vol: 22, Pages: H37-H39, ISSN: 1520-765X
Hypertension is highly prevalent in Chile. The National Health Survey 2016-17 reported a 27.6% prevalence, 68.7% awareness, and 33.3% of hypertensives had controlled blood pressure (BP). May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. A cross-sectional survey of volunteers aged ≥18 years old was carried out in May 2018. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Ninety-four sites participated, most of them from the Public Health System outpatient clinics distributed along the country. In addition, universities, clinical research sites, and private clinics participated. Hypertension was diagnosed as mean systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or receiving antihypertensive medication. Overall 9344 individuals were screened. After multiple imputation, hypertension prevalence was 29.2%, of which 64.0% were aware of their condition. Of those aware of their hypertension diagnosis, 87.7% were receiving antihypertensive medication and 56.1% of the total number of hypertensives were on antihypertensive medication. Moreover, 15.3% of the participants who were not receiving treatment were considered potential hypertensives identified in the MMM18. MMM18 was one of the largest BP screening campaigns performed in Chile. It demonstrated a high prevalence of hypertension with one-third of these individuals having controlled BP. The high percentage of persons untreated or with uncontrolled hypertension while on pharmacologic treatment suggests that systematic screening programmes may be a useful tool to improve hypertension control in Chile.
Lopez-Jaramillo P, Otero J, Alvernia J, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Colombia., European Heart Journal Supplements, Vol: 22, Pages: H43-H46, ISSN: 1520-765X
High blood pressure (BP) is the leading global preventable cause of death and the most common risk factor for cardiovascular disease (CVD). However, due to its asymptomatic nature, the lack of awareness of this condition causes underdiagnosis and low rates of adherence to pharmacological treatment. Looking for practical approaches to increase awareness worldwide, the International Society of Hypertension (ISH) implemented the 2nd May Measurement Month campaign in 2018 (MMM18). In order to contribute to this initiative, Colombia participated as one of the 89 countries involved in this hypertension screening programme. Blood pressure was measured in subjects from 11 departments in Colombia. Under the leadership of the Fundación Oftalmológica de Santander (FOSCAL), 400 volunteers across the country collected the data following the MMM protocol. Measurements from 35 548 participants with a mean age of 41.9 years were obtained. In total, 9475 (26.7%) of the total population studied had hypertension. Of those with hypertension, 69.9% of these subjects were aware of their condition, 65.0% were on antihypertensive medication, and 43.1% had controlled BP. Of those on medication, 66.3% had controlled BP. Hypertension screening, awareness, treatment, and control should be a priority in public health objectives due to its elevated burden of disease and direct association with increased CVD. The MMM campaign provided a positive impact in the diagnosis of hypertension across Colombia. Although efforts are being made to expand treatment capability and adherence, still more are needed to insure a broader coverage of antihypertensive medication in Colombia.
Ellenga Mbolla BF, Kouala Landa CM, Bakekolo PR, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Republic of the Congo., European Heart Journal Supplements, Vol: 22, Pages: H47-H49, ISSN: 1520-765X
To determine the proportion with hypertension among opportunistic screenees in the Republic of the Congo. This cross-sectional study was conducted in Republic of the Congo in May 2018. This screening was done in urban and rural areas that included Brazzaville, Pointe-Noire, District of Ngoyo, and District of Nkayi. The study protocol was provided by the International Society of Hypertension, and local ethical clearance was obtained. The data were processed by the May Measurement Month global project team. In total, 6169 people were screened, 2418 of which were female (39.2%). Most of the people screened were from 18 to 29 years old (n = 4184, 67.8%). The proportion of hypertension found was 22.2% (n = 1371). Among the hypertensive patients, 40.2% were aware of their hypertension, but only 493 (36.0%) were on antihypertensive treatment, and only 16.0% were controlled. The frequency of diabetes was 2.2% (n = 135), 2.3% (n = 139) had a previous stroke, and overweight and obesity were present in 15.4% (n = 952) and 7.3% (n = 449), respectively. Hypertension is frequent in the Republic of the Congo, and levels of awareness, treatment and control are low. Actions are needed to increase access of all to a correct diagnosis and treatment of hypertension to achieve universal health coverage.
Peñaherrera E, Beaney T, Ster AC, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Ecuador., European Heart Journal Supplements, Vol: 22, Pages: H53-H55, ISSN: 1520-765X
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 by the International Society of Hypertension (ISH) aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. A volunteer cross-sectional survey was carried out in May 2017 across 33 health centres. Blood pressure measurement, the definition of hypertension (HTN) (mean of the 2nd and 3rd BP measurement ≥ 140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 11 922 individuals (53.7% female) were screened during MMM18. After multiple imputation, 4563 (38.3%) had HTN. Of individuals not receiving antihypertensive medication, 1302 (15.0%) were hypertensive. Of individuals receiving antihypertensive medication, 933 (28.6%) had uncontrolled BP. MMM18 was the largest BP screening campaign done in Ecuador. Hypertension was detected in 38.4% of those screened and almost 4 out of 10 were either not on treatment or were not controlled to the BP goal. These results suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of doctors and health care system in Ecuador.
Buila NB, Ngoyi GN, Bayauli PM, et al., 2020, Analysis of blood pressure and selected cardiovascular risk factors in the Democratic Republic of the Congo: the may measurement month 2018 results., European Heart Journal Supplements, Vol: 22, Pages: H50-H52, ISSN: 1520-765X
Hypertension (HT) is the largest contributor to cardiovascular disease mortality and is characterized by high prevalence and low awareness, treatment, and control rates in sub-Saharan Africa. May Measurement Month (MMM) is an international campaign intended to increase awareness of high blood pressure (BP) among the population and advocate for its importance to the health authorities. This study aimed to increase awareness of raised BP in a country where its nationwide prevalence is yet unestablished. Investigators trained and tested how to use the campaign materials, collected participants' demographic data, lifestyle habits, and obtained from each one three BP measurements. Hypertension was defined as a BP ≥140/90 mmHg, or use of antihypertensive medication. Of the 18 719 screened (mean age 41 years; 61.4% men), 26.1% were found to be hypertensive of whom 46.3% were aware of their condition and 29.6% were taking antihypertensive medication. The control rate of HT was 43.0% in those on medication and 12.7% among all hypertensive respondents. Comorbidities found were-diabetes (3.3%), overweight/obesity (35.5%); and a previous stroke and a previous myocardial infarction were reported by 1.2% and 2.0%, respectively. Imputed age- and sex-standardized BP was higher in treated hypertensive individuals (135/85 mmHg) than those not treated (124/78 mmHg). Based on linear regression models adjusted for age and sex (and an interaction) and antihypertensive medication, stroke survivors, those who drank once or more per week (vs. never/rarely), and overweight/obese participants were associated with higher BP. MMM18 results in the Democratic Republic of the Congo corroborated the high prevalence of HT in Kinshasa screenees with low rates of treatment and control. Extension of the MMM campaign to other parts of the country is advisable.
Chen X, Li Y, Hu Z, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from China., European Heart Journal Supplements, Vol: 22, Pages: H40-H42, ISSN: 1520-765X
To further improve awareness, treatment, and control of hypertension, the May Measurement Month (MMM) campaign continued in 2018 in China. Study subjects were adults aged 18 years or more, ideally those who had not their blood pressure (BP) measured for at least a year. Blood pressure was measured three times consecutively with a 1-min interval in the sitting position, using automated BP monitors in 288 342 participants and transmitted to a central database by a smartphone app. Questionnaire data were collected with the same app. After imputation, the overall proportion of hypertension was 29.8%. Of those with hypertension, the rates of awareness, treatment, and control were 62.3%, 57.3%, and 35.9%, respectively. In analysis based on linear regression models, both systolic and diastolic BP were higher with cigarette smoking, alcohol intake, and overweight and obesity. Our study results suggest that hypertension management is improving in comparison with the data in MMM 2017 and the nationwide survey in 2012-15, and several known lifestyle factors are key to hypertension management.
Van Minh H, Lan Viet N, Sinh CT, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Vietnam., European Heart Journal Supplements, Vol: 22, Pages: H139-H141, ISSN: 1520-765X
Vietnam in the Asia Pacific region has a high hypertension (HTN) prevalence. The May Measurement Month (MMM) program was enthusiastically responded to in Vietnam by launching and deploying it across the whole country from 2017. The aims of the MMM 2018 program in Vietnam were to screen at least 15 000 people aged 18 and over across the country; to inform participants of the risks associated with HTN; and thereby define the proportion of subjects with elevated blood pressure (BP) and assess the awareness and the effectiveness of its treatment. An opportunistic cross-sectional survey of volunteers aged ≥ 18 was carried out in May 2018. Blood pressure measurement, the definition of HTN, and statistical analysis followed the standard MMM protocol. From May 2018 to June 2018, through 10 cities/provinces in Vietnam, 17 332 individuals with mean age 47.0 ± 17.9 years were screened during MMM18. After multiple imputation, 5260 (30.3%) had HTN. Of individuals not receiving antihypertensive medication, 1956 (13.9%) were hypertensive. Of patients receiving antihypertensive medication, 1540 (46.6%) had uncontrolled BP. Those who had HTN also displayed many additional risk factors similarly to MMM 2017 including smoking, alcohol, overweight-obesity, and diabetes. In conclusion, MMM 2018 campaign is a continuation program of MMM 2017 that has promoted the strength of the BP screening survey in the community in Vietnam, which hopefully will influence on awareness of disease prevention in this century. The next steps of the program will have special innovations on how to reduce the frequency of focusing on variable risk factors to change the overall picture of HTN in Vietnam.
Hernández-Hernández R, Duín A, Octavio-Seijas JA, et al., 2020, Results of may measurement Month 2018 campaign in Venezuela., European Heart Journal Supplements, Vol: 22, Pages: H135-H138, ISSN: 1520-765X
Cardiovascular diseases, mainly coronary heart disease and stroke, are the main cause of death in Venezuela; hypertension is the primary risk factor. The May Measurement Month (MMM) study is a global initiative aimed at raising awareness of elevated blood pressure (BP). The previous MMM 2017 campaign showed 48.9% of participants had hypertension, higher than previous Venezuelan epidemiological studies. The MMM 2018 campaign included 28 649 participants screened [mean age: 54.2 (SD 15.13) years; female 62.8%] carried out mainly in pharmacies in 61 sites. Physical measurements included height, weight, and BP, taken in sitting position three times. After multiple imputations, 48.4% had hypertension, of which 87.7% were aware of their diagnosis. Of the individuals not receiving antihypertensive medication, 14.0% had hypertension and 33.7% of those receiving treatment had uncontrolled hypertension. Overall, the percentage of hypertensives with controlled hypertension was 54.8%. Body mass index was calculated for the total population, and it was on average 25.2 (SD: 4.65) kg/m2. Of all, 14.2% was classified as obese and 32.6% as overweight; meanwhile 4.8% as underweight. Diabetes was reported by 9.5%. These results suggest that repeated screening like the MMM campaign can routinely identify hypertension and consequently implement programmes of treatment in Venezuela, also other common risk factors, like obesity or diabetes.
McDonnell BJ, Beaney T, Al Shezawi M, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from the UK and the Republic of Ireland., European Heart Journal Supplements, Vol: 22, Pages: H132-H134, ISSN: 1520-765X
Raised blood pressure (BP) was the biggest contributor to the global burden of disease in 2017, with lack of awareness and adequate control of BP identified as the main drivers of this disease burden. In 2017, an opportunistic BP screening and awareness campaign called May Measurement Month (MMM) in the UK and Republic of Ireland (RoI) highlighted that levels of undiagnosed hypertension and uncontrolled hypertension in the community screened were approximately 23% and 40%, respectively. MMM18 was undertaken to further the campaign's efforts to increase awareness and create an evidence base of population risk associated with high BP. MMM18 BP screenings were conducted in the community at places of worship, supermarkets, GP surgeries, workplaces, community pharmacies, gyms, and various other public places. A total of 5000 volunteers, aged 47.3 (±17.2) years, 60% female were screened. Of all 5000 individuals screened, 1716 (34.3%) were hypertensive, of which only 51.3% were aware of their condition, 42.8% on antihypertensive treatment, and only 51.5% of those on medication controlled to target BP of <140/90 mmHg. Furthermore, obese, overweight, and underweight participants all had significantly higher BP values compared to individuals with a healthy body mass index (BMI). The 2018 MMM campaign in the UK and the RoI confirmed approximately one in three adults were hypertensive, with more than half having uncontrolled BP. In addition, these findings show that people with low BMI are at risk of having high BP. Finally, with only one in two people aware of their high BP, awareness remains a significant public health concern.
Yusufali A, Bazargani N, Bin Belaila BA, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from United Arab Emirates., European Heart Journal Supplements, Vol: 22, Pages: H128-H131, ISSN: 1520-765X
Hypertension is one of the most important modifiable risk factors for cardiovascular disease and death even in high-income countries. According to the PURE Study, globally only half of hypertensives are aware and less than a fifth controlled. May Measurement Month (MMM) is a global campaign to raise awareness and screen for high blood pressure (BP) in lieu of formal screening. United Arab Emirates (UAE) has taken part in MMM since its inception and here data from MMM18 are reported. Trained volunteers from 54 sites screened 31 316 individuals from all the Emirates of UAE using convenience sampling. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. The mean age was 36.8 ± 11.4 years and 18 411(59%) were male. Participants of Arab descent were 11 829 (38%) and 11 569 (37%) were South Asian. Mean body mass index was 26.8 ± 5.29 kg/m2. Of those screened, 7 917 (25%) had never had a BP recorded, while 16 892 (54%) had recorded BP in the previous year. After imputation, 6 243 (20%) had hypertension. Of those participants, only 2 540 (41%) were aware and 2 331 (37%) were on antihypertensive medication, of which 61% were controlled. Of all hypertensives, only 23% were controlled. May Measurement Month in UAE expanded significantly compared to 2017. A quarter had never had BP measured and awareness of hypertension low (41%). This opportunistic screening method found a substantial number of adults with untreated or inadequately treated hypertension.
Beheiry HM, Abdalla AA, Fahal NA, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Sudan., European Heart Journal Supplements, Vol: 22, Pages: H122-H124, ISSN: 1520-765X
To raise awareness of high blood pressure (BP) levels and associated risk factors among the Sudanese population. A cross-sectional study was conducted in six Sudanese states during the period May-August 2018. The study area included public indoor and outdoor areas, institutes, and service facilities. A questionnaire for collecting the data was employed including demographic data, along with three consecutive BP measurements. Data were collected by trained volunteers. Hypertension (HTN) was defined as a systolic blood pressure ≥140 mmHg or a diastolic blood pressure ≥90 mmHg based on the mean of the second and third measurements, or in those on antihypertensive medication. The current study indicated a high prevalence of HTN (28.2%) among 40 779 participants and a low level of awareness (20.7%) amongst these participants. Of all, 18.2% of hypertensive participants were on medication and of these, 54.6% were controlled. Of all hypertensives, only 9.9% were controlled. Further action needs to be taken by all stakeholders for raising awareness and increasing screening provision of HTN, which are essential for the development of national health policies for control and management of HTN in Sudan.
Lin H-J, Pan H-Y, Beaney T, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Taiwan., European Heart Journal Supplements, Vol: 22, Pages: H125-H127, ISSN: 1520-765X
To raise awareness of hypertension in the general population, we have held an annual community-based nationwide campaign for blood pressure (BP) screening. The 2018 May Measurement Month (MMM) campaign in Taiwan followed a similar protocol as the 2017 MMM campaign. We recruited adults aged 20 years and older at about 800 community pharmacies across Taiwan. After a 10-min seated rest, volunteers-consisting of community pharmacists-took three BP readings using automated BP devices. The means of the 2nd and 3rd BP readings were used as the screening BP estimates. Hypertension was defined as current use of antihypertensive medications, or the screening BP of ≥140/90 mmHg. Of the 15 365 enrolled participants with a mean age of 56.8 ± 16.4 years, 53.3% were women. After imputation, we found 48.1% of the individuals had hypertension. Among participants with hypertension, 83.7% were aware, 55.0% had controlled BP, and 81.3% were medically treated, of whom 67.7% had controlled BP (<140/90 mmHg). In contrast to the global results, our results showed that the participants with diabetes mellitus, prior myocardial infarction, or stroke had higher BP than those without these comorbidities. The annual campaign experience enables us to establish a feasible approach to raising awareness and to assessing the management of hypertension in the general population. Whether the regular annual BP screening campaign makes a lasting effect on hypertension-related disease burden awaits verification.
Rodilla E, Molinero A, Gijón-Conde T, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Spain., European Heart Journal Supplements, Vol: 22, Pages: H119-H121, ISSN: 1520-765X
Elevated blood pressure (BP) is the single most important contributing risk factor to the global disease burden, leading to over 10 million deaths each year. In Spain, hypertension (HTN) affects around 20% of the adult population and remains the greatest attributable cause of cardiovascular mortality. May Measurement Month (MMM) is a worldwide initiative aimed at increasing awareness of HTN and to improve the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged 18 and over was carried out in May 2018. Blood pressure measurement, the definition of HTN and statistical analysis followed the standard MMM protocol. Anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors were obtained as additional information. Screening sites mainly in community pharmacies, universities, primary care centres, HTN units, and cardiovascular departments in hospitals were set up across Spain as part of this initiative. In total, 7646 individuals (63.5% female) were screened during MMM18. After multiple imputation, 40.0% had HTN, of whom 74.4% were aware of their diagnosis and 69.6% were taking antihypertensive medication. Of individuals not receiving antihypertensive medication, 16.9% were hypertensive. Of individuals receiving antihypertensive medication, 36.4% had uncontrolled BP. MMM18 almost doubled the number of participants of MMM17 and was the largest BP screening campaign ever undertaken in Spain, showing that in the absence of systematic screening programmes for HTN, MMM can identify a great number of individuals at risk, increasing their awareness and attracting the interest of the healthcare system in Spain.
Woodiwiss AJ, Kruger R, Norton GR, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results in South Africa., European Heart Journal Supplements, Vol: 22, Pages: H115-H118, ISSN: 1520-765X
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 of the International Society of Hypertension (ISH) aimed at raising awareness of high BP and acting as a temporary solution to the lack of screening programmes worldwide. As part of MMM, screening in South Africa in 2017 revealed that 24.5% of adults (mean age = 31 years) have hypertension and only half of those with hypertension had controlled BP. These data highlight the need for continued screening and awareness campaigns. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurements, the definition of hypertension and statistical analyses followed the MMM protocol. The sites screened were general populations and university campuses in preference to hospitals and clinics, aiming to raise awareness and allow access to screening to those less likely to be aware of their BP. In total, 2965 individuals (age 40.5 ± 18.2 years) were screened. After multiple imputation for missing BP readings, 34.6% had hypertension, only 56.7% of those with hypertension were aware, 21.2% of those not receiving treatment for hypertension were hypertensive, and a large proportion (42.5%) of individuals receiving antihypertensive medication had uncontrolled BP. These results suggest that opportunistic screening campaigns can identify significant numbers with undiagnosed and uncontrolled hypertension. The high proportions of individuals with undiagnosed and treated uncontrolled hypertension highlight the need for hypertension awareness campaigns and more rigorous management of hypertension.
Božič N, Knez J, Dolenc P, et al., 2020, May measurement month 2018: an analysis of blood pressure screening results from Slovenia., European Heart Journal Supplements, Vol: 22, Pages: H112-H114, ISSN: 1520-765X
Elevated blood pressure (BP) is a growing burden worldwide, contributing to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed to raise awareness of high BP. In May 2018, we carried out an opportunistic cross-sectional survey of volunteers from different parts of the country aged ≥18 years. Blood pressure measurement followed the standard MMM protocol and statistical analysis mean of the last 2 of 3 readings was used, where these were unavailable additional imputations were performed. In total, 4883 individuals (61.0% female) were screened during the whole month of May in 91 primary and secondary health facilities, pharmacies and through an online survey. After multiple imputation, 2841 (58.2%) had HTN. Of individuals not receiving antihypertensive medication, 850 (29.4%) were hypertensive. Of those receiving antihypertensive medication, 1025 (51.5%) had uncontrolled BP. MMM18 was the largest BP screening campaign undertaken in Slovenia. A substantial number of people with possible HTN were identified and referred to general practitioners for further management. The high number of individuals with HTN, with newly diagnosed HTN and with uncontrolled BP despite medication, confirms a real need for such screening programmes in our country.
Jankowski P, Banach M, Małyszko J, et al., 2020, May measurement month 2018: an analysis of blood pressure screening campaign results from Poland., European Heart Journal Supplements, Vol: 22, Pages: H108-H111, ISSN: 1520-765X
Hypertension remains the most important cardiovascular risk factor in Poland. May Measurement Month is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for blood pressure (BP) screening and demonstrating the potential of the opportunistic BP measurements. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 146 sites in May 2018. Blood pressure was measured in 6450 subjects (mean age: 41 ± 15 years; 59% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.7/78.4 mmHg in the whole analysed group, 132.8/81.3 mmHg in subjects taking antihypertensive drugs, and 125.7/78.0 mmHg in those not taking any antihypertensive drugs. After multiple imputation, the proportions of subjects with high BP (systolic ≥140 mmHg or diastolic ≥90 mmHg or on treatment for raised BP) were 22.2% in the whole analysed group, 39.2% in subjects taking antihypertensive drugs, and 18.6% those not taking any antihypertensive drugs. Overall, hypertension was present in 32.8% of participants, among them 38.7% were not aware of the disease, 53.1% were taking antihypertensive drugs, and 32.3% had BP controlled to target (<140/90 mmHg). Blood pressure was increasing with increasing body mass index and alcohol intake. Smokers and project participants with diabetes had increased average BP. In conclusion, this project provides additional evidence for a considerable potential for further reduction of cardiovascular risk through improvement in detection and treatment of hypertension in Poland.
Poulter NR, Borghi C, Burger D, et al., 2020, May measurement month 2018: results of blood pressure screening from 41 countries., European Heart Journal Supplements, Vol: 22, Pages: H1-H4, ISSN: 1520-765X
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