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Scola G, Chis Ster A, Bean D, Pareek N, Emsley R, Landau S. Implementation of the trial emulation approach in medical research: a scoping review. BMC Med Res Methodol 2023; 23:186. [PMID: 37587484 PMCID: PMC10428565 DOI: 10.1186/s12874-023-02000-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/25/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND When conducting randomised controlled trials is impractical, an alternative is to carry out an observational study. However, making valid causal inferences from observational data is challenging because of the risk of several statistical biases. In 2016 Hernán and Robins put forward the 'target trial framework' as a guide to best design and analyse observational studies whilst preventing the most common biases. This framework consists of (1) clearly defining a causal question about an intervention, (2) specifying the protocol of the hypothetical trial, and (3) explaining how the observational data will be used to emulate it. METHODS The aim of this scoping review was to identify and review all explicit attempts of trial emulation studies across all medical fields. Embase, Medline and Web of Science were searched for trial emulation studies published in English from database inception to February 25, 2021. The following information was extracted from studies that were deemed eligible for review: the subject area, the type of observational data that they leveraged, and the statistical methods they used to address the following biases: (A) confounding bias, (B) immortal time bias, and (C) selection bias. RESULTS The search resulted in 617 studies, 38 of which we deemed eligible for review. Of those 38 studies, most focused on cardiology, infectious diseases or oncology and the majority used electronic health records/electronic medical records data and cohort studies data. Different statistical methods were used to address confounding at baseline and selection bias, predominantly conditioning on the confounders (N = 18/49, 37%) and inverse probability of censoring weighting (N = 7/20, 35%) respectively. Different approaches were used to address immortal time bias, assigning individuals to treatment strategies at start of follow-up based on their data available at that specific time (N = 21, 55%), using the sequential trial emulations approach (N = 11, 29%) or the cloning approach (N = 6, 16%). CONCLUSION Different methods can be leveraged to address (A) confounding bias, (B) immortal time bias, and (C) selection bias. When working with observational data, and if possible, the 'target trial' framework should be used as it provides a structured conceptual approach to observational research.
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Affiliation(s)
- Giulio Scola
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Anca Chis Ster
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Bean
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Health Data Research UK London, Institute of Health Informatics, University College London, London, UK
| | - Nilesh Pareek
- King's College Hospital NHS Foundation Trust, London, UK
- School of Cardiovascular and Metabolic Medicine & Sciences, BHF Centre of Excellence, King's College London, London, UK
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Cro S, Kahan BC, Rehal S, Chis Ster A, Carpenter JR, White IR, Cornelius VR. Evaluating how clear the questions being investigated in randomised trials are: systematic review of estimands. BMJ 2022; 378:e070146. [PMID: 35998928 PMCID: PMC9396446 DOI: 10.1136/bmj-2022-070146] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate how often the precise research question being addressed about an intervention (the estimand) is stated or can be determined from reported methods, and to identify what types of questions are being investigated in phase 2-4 randomised trials. DESIGN Systematic review of the clarity of research questions being investigated in randomised trials in 2020 in six leading general medical journals. DATA SOURCE PubMed search in February 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Phase 2-4 randomised trials, with no restrictions on medical conditions or interventions. Cluster randomised, crossover, non-inferiority, and equivalence trials were excluded. MAIN OUTCOME MEASURES Number of trials that stated the precise primary question being addressed about an intervention (ie, the primary estimand), or for which the primary estimand could be determined unambiguously from the reported methods using statistical knowledge. Strategies used to handle post-randomisation events that affect the interpretation or existence of patient outcomes, such as intervention discontinuations or uses of additional drug treatments (known as intercurrent events), and the corresponding types of questions being investigated. RESULTS 255 eligible randomised trials were identified. No trials clearly stated all the attributes of the estimand. In 117 (46%) of 255 trials, the primary estimand could be determined from the reported methods. Intercurrent events were reported in 242 (95%) of 255 trials; but the handling of these could only be determined in 125 (49%) of 255 trials. Most trials that provided this information considered the occurrence of intercurrent events as irrelevant in the calculation of the treatment effect and assessed the effect of the intervention regardless (96/125, 77%)-that is, they used a treatment policy strategy. Four (4%) of 99 trials with treatment non-adherence owing to adverse events estimated the treatment effect in a hypothetical setting (ie, the effect as if participants continued treatment despite adverse events), and 19 (79%) of 24 trials where some patients died estimated the treatment effect in a hypothetical setting (ie, the effect as if participants did not die). CONCLUSIONS The precise research question being investigated in most trials is unclear, mainly because of a lack of clarity on the approach to handling intercurrent events. Clear reporting of estimands is necessary in trial reports so that all stakeholders, including clinicians, patients and policy makers, can make fully informed decisions about medical interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021238053.
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Affiliation(s)
- Suzie Cro
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - Brennan C Kahan
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | | | | | - James R Carpenter
- Medical Research Council Clinical Trials Unit at University College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ian R White
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - Victoria R Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
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Chis Ster A, Phillips R, Sauzet O, Cornelius V. Improving analysis practice of continuous adverse event outcomes in randomised controlled trials - a distributional approach. Trials 2021; 22:419. [PMID: 34187533 PMCID: PMC8243742 DOI: 10.1186/s13063-021-05343-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 05/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background Randomised controlled trials (RCTs) provide valuable information for developing harm profiles but current analysis practices to detect between-group differences are suboptimal. Drug trials routinely screen continuous clinical and biological data to monitor participant harm. These outcomes are regularly dichotomised into abnormal/normal values for analysis. Despite the simplicity gained for clinical interpretation, it is well established that dichotomising outcomes results in a considerable reduction in information and thus statistical power. We propose an automated procedure for the routine implementation of the distributional method for the dichotomisation of continuous outcomes proposed by Peacock and Sauzet, which retains the precision of the comparison of means. Methods We explored the use of a distributional approach to compare differences in proportions based on the comparison of means which retains the power of the latter. We applied this approach to the screening of clinical and biological data as a means to detect ‘signals’ for potential adverse drug reactions (ADRs). Signals can then be followed-up in further confirmatory studies. Three distributional methods suitable for different types of distributions are described. We propose the use of an automated approach using the observed data to select the most appropriate distribution as an analysis strategy in a RCT setting for multiple continuous outcomes. We illustrate this approach using data from three RCTs assessing the efficacy of mepolizumab in asthma or COPD. Published reference ranges were used to define the proportions of participants with abnormal values for a subset of 10 blood tests. The between-group distributional and empirical differences in proportions were estimated for each blood test and compared. Results Within trials, the distributions varied across the 10 outcomes demonstrating value in a practical approach to selecting the distributional method in the context of multiple adverse event outcomes. Across trials, there were three outcomes where the method chosen by the automated procedure varied for the same outcome. The distributional approach identified three signals (eosinophils, haematocrit, and haemoglobin) compared to only one when using the Fisher’s exact test (eosinophils) and two identified by use of the 95% confidence interval for the difference in proportions (eosinophils and potassium). Conclusion When dichotomisation of continuous adverse event outcomes aids clinical interpretation, we advocate use of a distributional approach to retain statistical power. Methods are now easy to implement. Retaining information is especially valuable in the context of the analysis of adverse events in RCTs. The routine implementation of this automated approach requires further evaluation. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05343-0.
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Affiliation(s)
- Anca Chis Ster
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, 1st Floor Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Rachel Phillips
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, 1st Floor Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Odile Sauzet
- Bielefeld School of Public health, Bielefeld University, Universitätstr. 25, 33 615, Bielefeld, Germany.,Centre for Statistics, Bielefeld University, Universitätstr. 25, 33 615, Bielefeld, Germany
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, 1st Floor Stadium House, 68 Wood Lane, London, W12 7RH, UK.
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Burazeri G, Qirjako G, Beaney T, Ster AC, Xia X, Ylli A, Muja H, Cumashi R, Dika Q, Roshi E, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Albania. Eur Heart J Suppl 2020; 22:H5-H7. [PMID: 32884455 PMCID: PMC7455298 DOI: 10.1093/eurheartj/suaa014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Genc Burazeri
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania.,Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Gentiana Qirjako
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Alban Ylli
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania
| | - Herion Muja
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania
| | - Rudina Cumashi
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania
| | - Qamil Dika
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania
| | - Enver Roshi
- Department of Public Health, Faculty of Medicine, University of Medicine, Rr. Dibres, No. 371, Tirana, Albania
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Tsinamdzgvrishvili B, Gamkrelidze A, Trapaidze D, Sturua L, Grdzelidze N, Abesadze T, Mebonia N, Shengelia L, Kereselidze M, Tkeshelashvili L, Vakhtangadze T, Asatiani N, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results in Georgia. Eur Heart J Suppl 2020; 22:H56-H58. [PMID: 32884471 PMCID: PMC7455291 DOI: 10.1093/eurheartj/suaa028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
May Measurement Month (MMM) is aimed at raising public awareness about arterial hypertension-the main risk factor for cardiovascular diseases in the population. Screening was carried out at 200 sites on a national scale. More than 500 volunteers, including doctors (80%) and medical students (20%) participated in the screening. To familiarize them with the research tools and standard blood pressure (BP) measurement method, their training was conducted by the Georgian Society of Hypertension in Tbilisi and other large cities. Social and mass media, medical societies, and other stakeholders were actively involved in the recruitment process. A total of 10 756 people were screened. The mean age of participants was 53.1 years (SD 16.1). Males-67.9%, females-32.1%. One hundred percent were White. After multiple imputation, the number of hypertensive patients was 6.037 (56.1%) and out of them 4950 were aware and 4701 (77.9%) were on medication, 1336 (22.1%) were not taking a medication. Of those taking antihypertensive medication, 38.2% had controlled BP. In spite of non-randomized selection and certain restrictions with respect to extrapolation of the results, MMM comprehensively reflects an urgent problem and major gaps in the health system. Based on the above, its importance is extremely valuable for identifying public health policy priorities.
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Affiliation(s)
- Bezhan Tsinamdzgvrishvili
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia.,Tsinamdzgvrishvili Cardiology Center, 2 Gudamakari Str., Tbilisi 0141, Georgia.,Department of Internal Diseases, Ivane Javakhishvili Tbilisi State University, Chavchavadze Ave., 2, Tbilisi 0128, Georgia
| | - Amiran Gamkrelidze
- National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia
| | - Dali Trapaidze
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia.,Tsinamdzgvrishvili Cardiology Center, 2 Gudamakari Str., Tbilisi 0141, Georgia.,Department of Internal Diseases, Ivane Javakhishvili Tbilisi State University, Chavchavadze Ave., 2, Tbilisi 0128, Georgia.,National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia
| | - Lela Sturua
- National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia.,PetreShotadze Tbilisi Medical Academy, Ketevan Tsamebuli Ave. 51/2, Tbilisi 0144, Georgia
| | - Nino Grdzelidze
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia.,National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia
| | - Tamar Abesadze
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia.,Tsinamdzgvrishvili Cardiology Center, 2 Gudamakari Str., Tbilisi 0141, Georgia
| | - Nana Mebonia
- National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia.,Tbilisi State Medical University, Vazha Pshavela Ave. 33, Tbilisi 0177, Georgia
| | - Lela Shengelia
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia.,National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia
| | - Maia Kereselidze
- National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia
| | - Lika Tkeshelashvili
- National Center for Disease Control and Public Health, Kakheti Highway 99, Tbilisi 0198, Georgia
| | - Tamar Vakhtangadze
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia.,Caucasus International University, 73 Chargali Str., Tbilisi 0141, Georgia
| | - Nino Asatiani
- Georgian Society of Hypertension, 2 Gudamakari Str., Tbilisi 0141, Georgia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Carnagarin R, Fonseca R, Brockman D, Critchley S, Tan I, Trengove N, Tan K, Lambert GW, Cowley D, Burrell LM, Poulter NR, Beaney T, Ster AC, Xia X, Schlaich MP. May Measurement Month 2018: an analysis of blood pressure screening results from Australia. Eur Heart J Suppl 2020; 22:H17-H19. [PMID: 32884459 PMCID: PMC7455264 DOI: 10.1093/eurheartj/suaa018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia
| | - Ricardo Fonseca
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Derrin Brockman
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia
| | | | | | | | - Kearney Tan
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia
| | | | - Diane Cowley
- Princess Alexandra Hospital (Queensland Health), Brisbane, Australia
| | - Louise M Burrell
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, UK.,Department of Primary Care and Public Health, Imperial College London
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, UK
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia.,Neurovascular Hypertension & Kidney Disease Laboratory, Alfred & Baker Hypertension Network, Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Royal Perth Hospital, Perth, Australia.,Department of Nephrology, Royal Perth Hospital, Perth, Australia
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Castillo RR, Mercado-Asis LB, Atilano AA, David-Ona DI, Diaz AF, Granada CN, Bonzon DD, Vilela GC, Chua CL, Gomez LA, Oliva RV, Morales DD, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening in the Philippines. Eur Heart J Suppl 2020; 22:H104-H107. [PMID: 32884485 PMCID: PMC7455274 DOI: 10.1093/eurheartj/suaa040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Rafael R Castillo
- Section of Cardiology, Department of Internal Medicine, Manila Doctors Hospital, 667 United Nations Avenue, Ermita, Manila 1000, Philippines.,CardioMetabolic Research Unit (CaMeRU), FAME Leaders Academy, 5F Narra Building, Pasong Tamo Extn, Makati City 1232, Philippines
| | - Leilani B Mercado-Asis
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Espana, Manila 1108, Philippines
| | - Alberto A Atilano
- Section of Cardiovascular Diseases, Department of Internal Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Espana, Manila 1108, Philippines
| | - Deborah Ignacia David-Ona
- Section of Hypertension, Department of Medicine, University of the Philippines College of Medicine-Philippine General Hospital, Taft Avenue, Manila 1000, Philippines
| | - Alejandro F Diaz
- Section of Neuro-Psychiatry, University of Santo Tomas, Espana, Manila, 1108 Philippines
| | - Carmela N Granada
- Department of Health, Disease Prevention and Control Bureau, San Lazaro Compound, Rizal Avenue, Manila 1008, Philippines
| | - Dolores D Bonzon
- Section of Physiology, University of the Philippines College of Medicine, Pedro Gil Street, Manila 1000, Philippines
| | - Gilbert C Vilela
- Department of Adult Cardiology, Philippine Heart Center, East Avenue, Quezon City 0850, Philippines
| | - Carlos L Chua
- Section of Neurology, Department of Internal Medicine, Manila Doctors Hospital, 667 United Nations Avenue, Ermita, Manila 1000, Philippines
| | - Lynn A Gomez
- Section of Nephrology, Department of Medicine, University of the Philippines-Philippine General Hospital, Taft Avenue, Manila 1000, Philippines
| | - Raymond V Oliva
- Section of Hypertension, Department of Medicine, University of the Philippines College of Medicine-Philippine General Hospital, Taft Avenue, Manila 1000, Philippines
| | - Dante D Morales
- Section of Cardiology, Department of Internal Medicine, Manila Doctors Hospital, 667 United Nations Avenue, Ermita, Manila 1000, Philippines
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Yusufali A, Bazargani N, Bin Belaila BA, Suhail AM, Shuri HH, Agrawal A, Muhammed K, Gabroun A, Albawab A, Vazir Z, Ravi Kumar R, Ghannam D, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from United Arab Emirates. Eur Heart J Suppl 2020; 22:H128-H131. [PMID: 32884492 PMCID: PMC7455288 DOI: 10.1093/eurheartj/suaa046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
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.
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Affiliation(s)
- Afzalhussein Yusufali
- Dubai Health Authority, Hatta Hospital, Dubai, UAE.,Dubai Medical University, Dubai, UAE
| | | | | | | | | | - Amrish Agrawal
- Ministry of Health and Prevention, Fujairah Hospital, Fujairah, UAE
| | | | | | - Amer Albawab
- Dubai Health Authority, Hatta Hospital, Dubai, UAE
| | - Zainab Vazir
- Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | | | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, St, Dunstan's Road UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
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9
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Nadar SK, Al-Riyami H, Al-Riyami A, Al-Lawati H, Panakkal B, Mohammed S, Nagaraju GB, Sharma SN, Abdulkader MM, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Oman. Eur Heart J Suppl 2020; 22:H100-H103. [PMID: 32884484 PMCID: PMC7455257 DOI: 10.1093/eurheartj/suaa039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
As per WHO estimates, around 17% of the adult Omani population are hypertensive. However, people with hypertension are often unaware of the diagnosis, and so the May Measurement Month (MMM) programme was set up to raise awareness of the importance of blood pressure (BP) screening. A cross-sectional screening of BP of subjects aged 18 years or more was carried out in May 2018 at various sites in Muscat, Oman. Screening sites were set up at the reception areas of participating hospitals, and at a few public areas such as shopping malls and workplaces of the volunteers. Blood pressure was measured according to a standardized protocol, and hypertension was defined as per the 2018 European Society of Hypertension guidelines. The data were analysed centrally by the MMM project team. A total of 12 689 individuals (mean age 40.6 ± 12.5 years, 72% male) were screened. The crude mean BP of the second and third readings (where three readings were taken, n = 4 738) was 127.1/79.2 mmHg. After multiple imputations, the average age and sex standardized BP was 127.3/80.2 mmHg. Of all participants, 29.8% had hypertension. There were 1 983 patients with a previous diagnosis of hypertension, of whom 1 810 were on antihypertensive medication. A further 1 973 subjects were newly diagnosed with hypertension. Of those on antihypertensive medication, 34.9% had uncontrolled BP readings. Screening programmes such as MMM are useful to identify persons with undiagnosed hypertension. However, more educational activities are required to increase the public awareness regarding the dangers of hypertension.
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Affiliation(s)
- Sunil K Nadar
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, 123, Oman
| | - Hassan Al-Riyami
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, 123, Oman
| | - Adil Al-Riyami
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, 123, Oman
| | - Hatim Al-Lawati
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, 123, Oman
| | - Benny Panakkal
- Department of Medicine, Badar Al-Samaa Hospital, Ruwi, Muscat, Oman
| | - Shafeek Mohammed
- Department of Medicine, Badar Al-Samaa Hospital, Ruwi, Muscat, Oman
| | - G B Nagaraju
- Department of Medicine, Badar Al-Samaa Hospital, Ruwi, Muscat, Oman
| | - S N Sharma
- Department of Medicine, Badar Al-Samaa Hospital, Ruwi, Muscat, Oman
| | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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10
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Ori B, Kowlessur S, Heecharan J, Poulter NR, Ster AC, Xia X, Beaney T. May Measurement Month 2018: an analysis of blood pressure screening results from Mauritius. Eur Heart J Suppl 2020; 22:H86-H88. [PMID: 32884480 PMCID: PMC7455285 DOI: 10.1093/eurheartj/suaa012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hypertension 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 blood pressure (HBP) and to act as a temporary solution to the lack of screening programmes worldwide. We here provide the results of the 2018 MMM (MMM18) edition in Mauritius. This cross-sectional survey of participants aged ≥18 years was carried out in May 2018. Hypertension was defined as systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg or both. Blood pressure (BP) measurement and statistical analysis followed the standard MMM protocol. Screening was conducted by Non-Communicable Diseases and Health Promotion Unit, which is under the aegis of the Ministry of Health and Quality of Life, mainly in workplaces and community centres, in both rural and urban areas across Mauritius. Of 5471 individuals screened, after multiple imputation, 786 (14.4%) had untreated hypertension. MMM18 was the largest BP screening campaign undertaken in Mauritius. These results suggest that MMM18 is very useful to identify significant numbers of patients with raised BP.
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Affiliation(s)
- Bhooshun Ori
- Ministry of Health and Wellness, Emmanuel Anquetil Building, Port Louis, Mauritius
| | - Sudhirsen Kowlessur
- NCD, Research and Health Promotion Unit, Ministry of Health and Wellness, Emmanuel Anquetil Building, Port Louis, Mauritius
| | - Jaysing Heecharan
- NCD, Research and Health Promotion Unit, Ministry of Health and Wellness, Emmanuel Anquetil Building, Port Louis, Mauritius
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
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11
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Zelveian P, Avagyan A, Minasyan A, Hayrumyan S, Gourgenyan S, Hakobyan Z, Kzhdryan H, Hakobjanyan V, Ustyan T, Gharibyan H, Melkonyan A, Aroyan S, Vatinyan S, Beaney T, Ster AC, Poulter NR. An analysis of blood pressure screening of 21 112 participants in Armenia: May Measurement Month 2018. Eur Heart J Suppl 2020; 22:H14-H16. [PMID: 32884458 PMCID: PMC7455293 DOI: 10.1093/eurheartj/suaa017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Parounak Zelveian
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia.,Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Avag Avagyan
- Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Arsen Minasyan
- Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Samvel Hayrumyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia.,Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Svetlana Gourgenyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia
| | - Zoya Hakobyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia.,Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Hovhannes Kzhdryan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia.,Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Vahan Hakobjanyan
- Armenian Medical Association, H. Tumanyan 38/9, Yerevan 0002, Armenia
| | - Tsiala Ustyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia
| | - Heghine Gharibyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia
| | - Arevik Melkonyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia
| | - Siranush Aroyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia
| | - Susanna Vatinyan
- Institute of Cardiology Named After L.A. Hovhannisyan, P. Sevak 5, Yerevan 0014, Armenia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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12
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Malik FTN, Al Mamun MA, Ishraquzzaman M, Kalimuddin M, Shahriar Huq T, Rahman MS, Choudhury SR, Ahmed N, Badiuzzaman M, Beaney T, Xia X, Ster AC, Malik A, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Bangladesh. Eur Heart J Suppl 2020; 22:H20-H22. [PMID: 32884460 PMCID: PMC7455272 DOI: 10.1093/eurheartj/suaa086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Fazila-Tun-Nesa Malik
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Mohammad Abdullah Al Mamun
- Department of Epidemiology & Research, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Mir Ishraquzzaman
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Mohammad Kalimuddin
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Tawfiq Shahriar Huq
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Mohammad Shamimur Rahman
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Sohel Reza Choudhury
- Department of Epidemiology & Research, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Nazir Ahmed
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Mohammad Badiuzzaman
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Abdul Malik
- Department of Cardiology, National Heart Foundation Hospital & Research Institute, Plot 7/2, Section 2, Mirpur, Dhaka, 1216, Bangladesh
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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13
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Azevedo V, Dias L, Soares I, Garcia G, Xia X, Ster AC, Beaney T, Poulter NR. May Measurement Month 2018: an analyses of blood pressure screening results from Cabo Verde. Eur Heart J Suppl 2020; 22:H30-H32. [PMID: 32884463 PMCID: PMC7455268 DOI: 10.1093/eurheartj/suaa020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Vanda Azevedo
- Cabo Verde College of Cardiology - Cabo Verde Medical Association, OUA Avenue No 6, Praia CP 421, Cabo Verde.,Ministry of Health and Social Security, Govern Palace, Praia, Cabo Verde
| | - Luís Dias
- Cabo Verde College of Cardiology - Cabo Verde Medical Association, OUA Avenue No 6, Praia CP 421, Cabo Verde.,Ministry of Health and Social Security, Govern Palace, Praia, Cabo Verde
| | - Irenita Soares
- Cabo Verde College of Cardiology - Cabo Verde Medical Association, OUA Avenue No 6, Praia CP 421, Cabo Verde.,Ministry of Health and Social Security, Govern Palace, Praia, Cabo Verde
| | - Glenda Garcia
- Ministry of Health and Social Security, Govern Palace, Praia, Cabo Verde
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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14
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Ndhlovu HLL, Masiye JK, Chirwa ML, Nyirenda NM, Dhlamini TD, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Malawi. Eur Heart J Suppl 2020; 22:H80-H82. [PMID: 32884478 PMCID: PMC7456181 DOI: 10.1093/eurheartj/suaa034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Raised blood pressure (BP) is a growing health care problem in the world leading to over 10 million deaths annually. May Measurement Month (MMM), which aims at raising awareness and screening people for raised BP, is assisting people to know their BP status. In 2018, an opportunistic cross-sectional survey was carried out during May and June in 10 791 volunteers aged 18 years and above following that done in 2017. The screening took place in Lilongwe, Blantyre, Dedza, Kasungu, and Nkhatabay districts mostly in hospitals/clinics, marketplaces, workplaces, and churches/mosques with Kasungu and Nkhatabay in rural areas. After multiple imputation, 2404 (22.3%) had hypertension. Of individuals not receiving antihypertensive treatment, 2101 (20.0%) were found to have raised BP. Only 303 (12.6%) of those with hypertension were receiving antihypertensive treatment, and of these 101 (33.3%) had uncontrolled BP. MMM was the largest BP screening campaign ever undertaken in Malawi. The results identified a large number of individuals with raised BP who were unaware and not on treatment and over one-third of those on treatment were uncontrolled, indicating the need for better management of cases. These results suggest that opportunistic screening can identify significant numbers with raised BP.
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Affiliation(s)
- Henry L L Ndhlovu
- Moyowathu HealthCare Services, Area 49, Off Kaunda Road, At Shoprite Bus Stage, Near old C.C.A.P, Lilongwe, Malawi
| | - Jones K Masiye
- Ministry of Health Headquarters, Non-Communicable Diseases and Mental Health Department, Lilongwe, Malawi
| | - Maureen L Chirwa
- Prime Health Consulting and Services, Plot No Area 47/5/240, Malingunde Road, Area 47, Lilongwe, Malawi
| | | | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8 RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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15
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Jankowski P, Banach M, Małyszko J, Mastej M, Tykarski A, Narkiewicz K, Hoffman P, Nowicki MP, Tomasik T, Windak A, Olszanecka A, Tomaszewskil M, Motyl A, Nowak D, Skowron Ł, Beaney T, Ster AC, Xin X, Poulter NR, Jóźwiak J. May Measurement Month 2018: an analysis of blood pressure screening campaign results from Poland. Eur Heart J Suppl 2020; 22:H108-H111. [PMID: 32884486 PMCID: PMC7455275 DOI: 10.1093/eurheartj/suaa041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
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.
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Affiliation(s)
- Piotr Jankowski
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, Kraków 31-501, Poland
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Żeromskiego 113, Łódz 90-549, Poland
| | - Jolanta Małyszko
- Department of Nephrology, Dialysis and Internal Medicine, Warsaw Medical University, Banacha 1a, Warszawa 02-097, Poland
| | | | - Andrzej Tykarski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa1/2, Poznan 61-848, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Dębinki 7, Gdansk 80-952, Poland
| | - Piotr Hoffman
- Department of Congenital Heart Disease, Institute of Cardiology, Alpejska 42, Warszawa 04-628, Poland
| | - Michał P Nowicki
- Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Pomorska 251, Łódz 92-213, Poland
| | - Tomasz Tomasik
- Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, Bocheńska 4, Kraków 31-061, Poland
| | - Adam Windak
- Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, Bocheńska 4, Kraków 31-061, Poland
| | - Agnieszka Olszanecka
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kopernika 17, Kraków 31-501, Poland
| | - Maciej Tomaszewskil
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| | | | - Dariusz Nowak
- Municipal Hospital, Mickiewicza 12, Częstochowa 42-200, Poland
| | - Łukasz Skowron
- Department of Gastroenterology, Endocrinology and Internal Diseases, Military Institute of Medicine, Szaserów 128, Warszawa 04-141, Poland
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xia Xin
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Jacek Jóźwiak
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Opole, Oleska 48, Opole 45-052, Poland
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16
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Torlasco C, Faini A, Ferri C, Grassi G, Salvetti M, Destro M, Cicero AFG, Galletti F, Ghiadoni L, Carugo S, Sarzani R, Minuz P, Morganti A, Mulatero P, Mulè G, Savoia C, Volpe M, Borghi C, Beaney T, Ster AC, Poulter NR, Xia X, Parati G. May Measurement Month 2018: an analysis of blood pressure screening results from Italy. Eur Heart J Suppl 2020; 22:H70-H73. [PMID: 32884475 PMCID: PMC7455302 DOI: 10.1093/eurheartj/suaa032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cardiovascular (CV) diseases are burdened by high mortality and morbidity, being responsible for half of the deaths in Europe. Although hypertension is recognized as the most important CV risk factor, hypertension awareness and blood pressure (BP) control are still unsatisfactory. In 2017, 30.6% of a >10 000 individual sample who took part in the May Measurement Month (MMM) campaign in Italy was found to have high BP. To raise awareness on the hypertension issue and to report BP data on a nation-wide scale in Italy. In the frame of the MMM campaign, 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. Screenings were conducted in multiple sites by health care personnel. Among the 5554 people screened (females: 48.3%, mean age 58 ± 17 years) mean BP was 127/77 mmHg, and after imputations, 1462 (26.3%) participants were found to have high BP levels. Body mass index >25 was associated with higher systolic BP and diastolic BP (DBP), while diabetes was associated with high DBP only. Our data provide a nation-wide snapshot of BP control in a sample of individuals participating in a national health care campaign, and confirm the power of this kind of healthcare-related activities in reaching a significant number of people to raise awareness on health topics. The apparent positive trend in BP control compared to available data from other similar campaigns carried out during the past years needs to be confirmed with more methodologically robust studies.
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Affiliation(s)
- Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, piazza Santa Margherita 2, 67100, L'Aquila, Italy
| | - Guido Grassi
- Policlinico di Monza, Via Amati, 111 - 20900, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Massimo Salvetti
- Department of Clinical & Experimental Sciences and Postgraduate School of Emergency & Urgency Medicine, University of Brescia, Via Amati, 111 - 20900, Brescia, Italy.,2a Medicina-ASST Spedali Civili Brescia, Piazzale Spedali Civili, 1 25123, Brescia, Italy
| | - Maurizio Destro
- Medical Science, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, Italy
| | - Arrigo F G Cicero
- Medical and Surgical Sciences Department, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, Naples, Via Pansini, 5 - 80131, Italy.,"Federico II" University of Naples Medical School, Corso Umberto I 40, Naples, 80138, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Lungarno Antonio Pacinotti, 43, 56121, Italy
| | - Stefano Carugo
- Division of Cardiology, San Paolo University Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy.,Department of Health Sciences, University of Milan, ia Festa del Perdono, 7, 20122, Milan, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS INRCA, Via Festa del Perdono, 7, 20122, Ancona, Italy.,Department of Clinical and Molecular Sciences, University 'Politecnica delle Marche', ia Tronto, 10/a, 60126, Ancona, Italy
| | - Pietro Minuz
- Department of Medicine, Unit of General Medicine for the Study and Treatment of Hypertensive Disease, Policlinico GB Rossi, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Alberto Morganti
- Centro Fisiologia Clinica e Ipertensione, Ospedale Policlinico, Università Milano, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Via Giuseppe Verdi, 8, 10124, Torino, Italy
| | - Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Piazza Marina, 61, 90133, Palermo, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Cardiology Unit Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035/1039, 00189, Via di Grottarossa, 1035/1039, 00189, Rome, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa, 1035/1039, 00189, Rome, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
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17
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Wahab KW, Kolo PM, Sani MU, Okubadejo NU, Peter JO, Aigbe F, Makusidi MA, Aje A, Adewale A, Adebola P, Beaney T, Ster AC, Poulter NR, Xia X, Omotoso AB. May Measurement Month 2018: an analysis of blood pressure screening results from Nigeria. Eur Heart J Suppl 2020; 22:H96-H99. [PMID: 32884483 PMCID: PMC7455261 DOI: 10.1093/eurheartj/suaa038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hypertension remains the dominant cardiovascular risk factor worldwide. May Measurement Month (MMM) is an annual global programme of the International Society of Hypertension aimed at screening for undetected hypertension in the general population. We report the outcome of MMM 2018 in Nigeria. An opportunistic screening of adults aged at least 18 years was conducted in the six geopolitical zones of Nigeria in the month of May, 2018. Screening for hypertension was done by trained volunteers with the use of validated digital and mercury sphygmomanometers following the MMM protocol. Hypertension was defined as blood pressure (BP) ≥140/90 mmHg or the use of BP-lowering medication. There were 6398 participants (53.0% female) with a mean (SD) age of 41.7 (15.0) years. Hypertension was present in 36.4% of the participants with 51.1% of the hypertensives aware of their status, 41.8% on medication, of whom 43.1% were controlled. Overall, only 18.0% of all hypertensive participants had their BP under control. The proportion with hypertension is high, and awareness, treatment, and control rates are low. Concerted efforts are needed to improve awareness and treatment of hypertension in Nigeria in order to reduce the high rate of complications associated with uncontrolled BP.
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Affiliation(s)
- Kolawole W Wahab
- Department of Medicine, University of Ilorin, Old Jebba Road, Ilorin 240003, Nigeria
| | - Philip M Kolo
- Department of Medicine, University of Ilorin, Old Jebba Road, Ilorin 240003, Nigeria
| | - Mahmoud U Sani
- Department of Medicine, Bayero University, BUK New Site, Kano 700241, Nigeria
| | - Njide U Okubadejo
- Department of Medicine, University of Lagos, Idi Araba, Lagos 100254, Nigeria
| | - Johnson O Peter
- Department of Medicine, Ladoke Akintola University of Technology, Isale Osun, Osogbo 230231, Nigeria
| | - Fred Aigbe
- Department of Medicine, Niger Delta University Teaching Hospital, Oghara via Sapele, Oghara 331101, Nigeria
| | - Muhammad A Makusidi
- Department of Medicine, Usmanu Dan Fodiyo University, Gawo Nama, Sokoto 840232, Nigeria
| | - Akinyemi Aje
- Department of Medicine, University College Hospital, Queen Elizabeth Road, Ibadan 200212, Nigeria
| | - Arimiyau Adewale
- Department of Medicine, Federal Medical Centre, 1 Salihu Ibrahim Way, Lokoja 260101, Nigeria
| | - Phillip Adebola
- Department of Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, Ikeja 100001, Nigeria
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Ayodele B Omotoso
- Department of Medicine, University of Ilorin, Old Jebba Road, Ilorin 240003, Nigeria
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18
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Espeche WG, Rojas C, Stisman D, Fuentes A, Fita M, Lacunza CD, Marquez D, Grosse P, Bueno D, Zilberman J, Beaney T, Ster AC, Poulter NR, Marín M, Ennis IL. May Measurement Month 2018: an analysis of blood pressure screening results from Argentinean cohort. Eur Heart J Suppl 2020; 22:H11-H13. [PMID: 32884457 PMCID: PMC7455283 DOI: 10.1093/eurheartj/suaa016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Walter G Espeche
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Cristina Rojas
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Diego Stisman
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Analia Fuentes
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Fita
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Carlos Diego Lacunza
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Diego Marquez
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Pedro Grosse
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Dennis Bueno
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Judith Zilberman
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Marcos Marín
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
| | - Irene L Ennis
- Sociedad Argentina de Hipertensión Arterial, Tte. Gral. Juan Domingo Perón 1479, Piso 2 "4", C1037ACA Ciudad Autónoma de Buenos Aires, Argentina
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19
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Buila NB, Ngoyi GN, Bayauli PM, Katamba FK, Lubenga YN, Kazadi SM, Kiadi GD, Lepira FB, Kabanda GK, Kika ML, Beaney T, Ster AC, Poulter NR, M'Buyamba-Kabangu JR. Analysis of blood pressure and selected cardiovascular risk factors in the Democratic Republic of the Congo: the May Measurement Month 2018 results. Eur Heart J Suppl 2020; 22:H50-H52. [PMID: 32884469 PMCID: PMC7455259 DOI: 10.1093/eurheartj/suaa027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
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.
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Affiliation(s)
- Nathan B Buila
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Georges N Ngoyi
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Pascal M Bayauli
- Division of Endocrinology and Nuclear Medicine, University of Kinshasa Hospital, Kinshasa 11, Democratic Republic of the Congo
| | - Fortunat K Katamba
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Yves N Lubenga
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Serge M Kazadi
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Glodie D Kiadi
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - François B Lepira
- Division of Nephrology, Kinshasa School of Medicine, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Gilbert K Kabanda
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
| | - Mireille L Kika
- Programme National de Lutte contre les Maladies Cardiovasculaires, Ministère de la Santé Publique, Kinshasa Gombe, Democratic Republic of the Congo
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Jean-René M'Buyamba-Kabangu
- Hypertension Unit, Division of Cardiology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Kinshasa 11, Democratic Republic of the Congo
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20
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Van Minh H, Lan Viet N, Sinh CT, Hung PN, Ngoc NTM, Van Hung N, Son TK, Đong NT, Thang ĐC, Thuan ND, Dinh Thoan N, Tien HA, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Vietnam. Eur Heart J Suppl 2020; 22:H139-H141. [PMID: 32884495 PMCID: PMC7455300 DOI: 10.1093/eurheartj/suaa049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Huynh Van Minh
- Department of Cardiology, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen, Hue City 530000, Vietnam
| | - Nguyen Lan Viet
- Department of Cardiology, Vietnam Heart Institute, 1 Ton that Tung, Hanoi 100000, Vietnam
| | - Cao Thuc Sinh
- Department of Cardiology, Vinh Medical School, 161 Nguyen Phong Sac, Vinh 460000, Vietnam
| | - Phan Nam Hung
- Department of Cardiology, Qui Nhon Hospital, 106 Nguyen Hue, Qui Nhon 820000, Vietnam
| | - Nguyen Thi Mong Ngoc
- Department of Administration, Phu Yen Health Service, 4 To Huu, Phu Yen 620000, Vietnam
| | - Ngo Van Hung
- Department of Cardiology, Daklak Hospital, 2 Mai Hac De, Ban Me Thuot 630000, Vietnam
| | - Tran Kim Son
- Department of Cardiology, Can Tho Medical and Pharmacy University, 179 Nguyen Van Cu, Can Tho 900000, Vietnam
| | - Nguyen Ta Đong
- Department of Cardiology, Hue Central Hospital, 16 Le Loi, Hue 530000, Vietnam
| | - Đoan Chi Thang
- Department of Cardiology, Hue Central Hospital, 16 Le Loi, Hue 530000, Vietnam
| | - Nguyen Duc Thuan
- Department of Administration, Lam Dong Health Service, 6 Tran hung Dao, Dalat 670000, Vietnam
| | - Nguyen Dinh Thoan
- Department of Administration, Nha Trang Health Service, 3 Han Thuyen, Nha Trang 650000, Vietnam
| | - Hoang Anh Tien
- Department of Cardiology, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen, Hue City 530000, Vietnam
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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21
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Masupe T, Tlhakanelo JT, Tiro MB, Motlhatlhedi K, Mamela A, Makwati O, Kololo M, Phuswane O, Lesetedi O, Motlhagodi A, Beaney T, Ster AC, Poulter NR, Xia X, Mosepele M. May Measurement Month 2018: an analysis of blood pressure screening results from Botswana. Eur Heart J Suppl 2020; 22:H23-H25. [PMID: 32884461 PMCID: PMC7455262 DOI: 10.1093/eurheartj/suaa021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
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.
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Affiliation(s)
- Tiny Masupe
- Department of Family Medicine & Public Health, University of Botswana, Corner Notwane & Mobuto Road, Gaborone, Botswana
| | - John Thato Tlhakanelo
- Department of Family Medicine & Public Health, University of Botswana, Corner Notwane & Mobuto Road, Gaborone, Botswana
| | - Mary Banyana Tiro
- National Health Institutes of Health Sciences, Lobatse, Gaborone, Botswana
| | - Keneilwe Motlhatlhedi
- Department of Family Medicine & Public Health, University of Botswana, Corner Notwane & Mobuto Road, Gaborone, Botswana
| | - Abraham Mamela
- Infers Group, Unit 12A, Plot 4921 Village Health and Recreation Club Complex, Marataditaba and Okwa, Gaborone, Botswana
| | - Obuile Makwati
- South East District Health Management Team, Ministry of Health & Wellness, Ramotswa, Botswana
| | - Masego Kololo
- South East District Health Management Team, Ministry of Health & Wellness, Ramotswa, Botswana
| | - Orapeleng Phuswane
- Department of Family Medicine & Public Health, University of Botswana, Corner Notwane & Mobuto Road, Gaborone, Botswana
| | - Onalethata Lesetedi
- Department of Family Medicine & Public Health, University of Botswana, Corner Notwane & Mobuto Road, Gaborone, Botswana
| | - Amogelang Motlhagodi
- Department of Family Medicine & Public Health, University of Botswana, Corner Notwane & Mobuto Road, Gaborone, Botswana
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Mosepele Mosepele
- Department of Internal Medicine, University of Botswana Corner Notwane & Mobuto Road, Gaborone, Botswana
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22
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Ogola EN, Barasa A, Gachemba YM, Barasa F, Gitura BM, Nalwa W, Wairagu A, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening from Kenya. Eur Heart J Suppl 2020; 22:H74-H76. [PMID: 32884476 PMCID: PMC7455294 DOI: 10.1093/eurheartj/suaa033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hypertension (HTN) is highly prevalent and the leading cardiovascular risk factor for death globally. A large proportion of individuals with high blood pressure (BP) are unaware leading to under treatment and poor control. To address this, the International Society of Hypertension (ISH) initiated a global mass screening campaign, the May Measurement Month 2017 (MMM17), in which Kenya participated. Following the success of the campaign, its successor MMM18 was launched. Here, we present the Kenyan results for MMM18. Opportunistic screening of consenting adults was done in various sites across Kenya in May 2018, by volunteers trained using ISH material, under the co-ordination of the Kenya Cardiac Society. Blood pressure, pulse rate, weight, and height were measured by standard methods. Definitions of HTN and statistical methods all adhered to the standard MMM protocol. We screened 49 548 subjects, mean age 39.95 (15.3) years. In total, 49.4% had never had a BP measurement taken. After multiple imputation, 17.1% were hypertensive and of those who were hypertensive, 30.7% were aware, 26.6% were on antihypertensive treatment, and 13.0% had controlled BP. Alcohol use, excess weight, and treatment for HTN were associated with higher BP. The Kenyan MMM18 sites successfully screened more than three times the number screened in 2017, hence improving public awareness. Less than half the population had ever had a BP check. Less than a third of the hypertensives were aware with correspondingly poor treatment and control rates. Opportunistic mass screening is useful in raising public awareness.
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Affiliation(s)
- Elijah N Ogola
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Ngong Road, Nairobi 00202, Kenya
| | - Anders Barasa
- Department of Medicine, Aga Khan University, 808 Muthaiga Heights, Nairobi 00100, Kenya
| | - Yubrine M Gachemba
- Department of Medicine, Egerton University, PO Box 536, Nakuru 20115, Kenya
| | - Felix Barasa
- Department of Medicine, Moi Teaching and Referral Hospital, Nandi Road, Eldoret 30100, Kenya
| | - Bernard M Gitura
- Cardiology Unit, Kenyatta National Teaching and Referral Hospital, Ngong Road, Nairobi 00202, Kenya
| | - Wafula Nalwa
- School of Medicine, City Campus, Maseno University, Private Bag 40100, Kisumu, Kenya
| | - Anne Wairagu
- Gatundu Level 5 Hospital, PO Box 84, Gatundu 01030, Kenya
| | - Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK.,Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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23
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Victória Pereira S, Neto M, Feijão A, Oliveira P, Brandão M, Soito E, Mbala C, João A, Manuel C, Mundombe L, Muela H, Beaney T, Ster AC, Poulter NR, Fernandes M. May Measurement Month 2018: an analysis of blood pressure screening results from Angola. Eur Heart J Suppl 2020; 22:H8-H10. [PMID: 32884456 PMCID: PMC7455290 DOI: 10.1093/eurheartj/suaa015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
| | - Marisa Neto
- Serviço de Cardiologia-Hospital Josina Machel, Largo Josina Machel, Luanda, Angola
| | - Ana Feijão
- Serviço de Cardiologia-Hospital Américo Boavida Avenida Hoji Ya Henda, Luanda, Angola
| | | | - Maria Brandão
- Hospital Geral de Malanje, Centro Cidade, Malanje, Angola
| | - Ermelinda Soito
- Hospital Geral Materno-Infantil, Rua Machado Saldanha, Luanda, Angola
| | - Claudio Mbala
- Serviço de Cardiologia-Clínica Multiperfil, Rua Morro Bento, Samba, Luanda, Angola
| | - Armando João
- Hospital dos Cajueiros, Rua dos Comandos, Cazenga, Luanda, Angola
| | | | - Leonardo Mundombe
- Hospital Provincial Dr. António Agostino Neto, Rua Hospital, N'Dalatando, Canza-Norte, Angola
| | - Henrique Muela
- Departamento de Fisiologia-Faculdade de Medicina Agostinho Neto, Avenida Hoji Ya Henda, Luanda, Angola
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Mário Fernandes
- Serviço de Cardiologia-Hospital Américo Boavida Avenida Hoji Ya Henda, Luanda, Angola
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24
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Peñaherrera E, Beaney T, Ster AC, Poulter NR, Villalba J, Ramirez MI, Duarte Y, Caceres S, Mora C, Peñaherrera R, Avila E, Arteaga F, Bravo J, Hidalgo E. May Measurement Month 2018: an analysis of blood pressure screening results from Ecuador. Eur Heart J Suppl 2020; 22:H53-H55. [PMID: 32884470 PMCID: PMC7455296 DOI: 10.1093/eurheartj/suaa010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Ernesto Peñaherrera
- Hospital Luis Vernaza, Guayaquil, Ecuador.,Universidad Espiritu Santo, Guayaquil, Ecuador
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Jose Villalba
- Departamento Medico del Municipio de Quito, Quito, Ecuador
| | - Maria Isabel Ramirez
- Hospital Luis Vernaza, Guayaquil, Ecuador.,Universidad Católica, Guayaquil, Ecuador
| | - Yan Duarte
- Hospital Luis Vernaza, Guayaquil, Ecuador.,Universidad de Guayaquil, Guayaquil, Ecuador
| | | | | | | | - Elisa Avila
- Universidad Espiritu Santo, Guayaquil, Ecuador
| | | | | | - Eric Hidalgo
- Universidad Tecnica Particular de Loja, Loja, Ecuador
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25
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Woodiwiss AJ, Kruger R, Norton GR, Schutte AE, Myburgh C, Nkeh-Chungag B, Sewani-Rusike CR, Vally M, Jones E, Peterson V, Marsh J, Gafane-Matemane LF, Ahiante BO, Phalane E, Beaney T, Chis Ster A, Xia X, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results in South Africa. Eur Heart J Suppl 2020; 22:H115-H118. [PMID: 32884488 PMCID: PMC7455273 DOI: 10.1093/eurheartj/suaa043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Angela J Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Ruan Kruger
- MRC Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Building C1, 53 Borcherd Street, Potchefstroom, 2531, South Africa.,Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, 53 Borcherd Street, Potchefstroom, 2531, South Africa
| | - Gavin R Norton
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Aletta E Schutte
- MRC Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Building C1, 53 Borcherd Street, Potchefstroom, 2531, South Africa.,Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, 53 Borcherd Street, Potchefstroom, 2531, South Africa
| | - Caitlynd Myburgh
- Department of Life and Consumer Sciences, University of South Africa (UNISA), Science Campus, Roodepoort, 1732, South Africa
| | - Benedicta Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Science, Walter Sisulu University, Unitra, 5117, Mthatha, South Africa
| | - Constance R Sewani-Rusike
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Unitra, 5117, Mthatha, South Africa
| | - Muhammed Vally
- Pharmacology Division, Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, South Africa
| | - Erika Jones
- Division of Nephrology and Hypertension, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, Cape Town, South Africa
| | - Vernice Peterson
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Justin Marsh
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Lebo F Gafane-Matemane
- MRC Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Building C1, 53 Borcherd Street, Potchefstroom, 2531, South Africa.,Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, 53 Borcherd Street, Potchefstroom, 2531, South Africa
| | - Blessing O Ahiante
- Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, 53 Borcherd Street, Potchefstroom, 2531, South Africa
| | - Edith Phalane
- Hypertension in Africa Research Team, Faculty of Health Sciences, North-West University, 53 Borcherd Street, Potchefstroom, 2531, South Africa
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
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26
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Maheshwari A, Verma N, Bhardwaj S, Jose AP, Bhalla S, More A, Patil M, Gupta A, Gupta BK, Takalkar A, Gupta P, Pandey N, Patil V, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening campaign results in India. Eur Heart J Suppl 2020; 22:H62-H65. [PMID: 32884473 PMCID: PMC7455263 DOI: 10.1093/eurheartj/suaa030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hypertension (HTN) is the greatest attributable risk factor for cardiovascular disease in India. Recent studies have reported the crude prevalence of HTN in India to be 25.3%. In the May Measurement Month (MMM) screening campaign of 2017 conducted in India, 31.8% had HTN. In order to ratify earlier results, and further understand the awareness and control levels of HTN in India, organizations that participated in MMM 2017 decided to participate in the MMM global screening initiative of the International Society of Hypertension for a 2nd consecutive year. A total of 345 234 individuals were screened in MMM 2018. There were more than 1000 screening locations that included hospitals, clinics, workplaces, and special health camps organized across the country. After applying multiple imputation, a total of 111 462 (32.3%) individuals had HTN of whom 63 415 (55.6%) were aware of HTN and 61 646 (55.3%) were on antihypertensive medicines, out of which 15 583 (25.3%) were uncontrolled. Overall 57 864 (41.3%) hypertensives were uncontrolled. About half (44.7%) of hypertensive population in India were not on treatment. Around two-thirds (65.7%, n = 226 924) had not measured their blood pressure (BP) in last 12 months and 64% measured their BP for the first time in their life during the campaign, which strongly indicates the need for large scale awareness drives. This study suggests that opportunistic periodic public health screening at a national level is needed to increase HTN detection, treatment, control, and countrywide awareness in highly populated nations like India.
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Affiliation(s)
- Anuj Maheshwari
- Department of General Medicine, Babu Banarasi Das University, Lucknow, Uttar Pradesh 226028, India
- Indian Society of Hypertension, King George's Medical University, Shah Mina Road, Chowk, Lucknow, Uttar Pradesh 226003, India
| | - Narsingh Verma
- Indian Society of Hypertension, King George's Medical University, Shah Mina Road, Chowk, Lucknow, Uttar Pradesh 226003, India
- Department of Physiology, KGMU, Lucknow, Uttar Pradesh, India
| | - Shipra Bhardwaj
- Indian Society of Hypertension, King George's Medical University, Shah Mina Road, Chowk, Lucknow, Uttar Pradesh 226003, India
- Dr RML Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arun P Jose
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot 47, Sector 44, Gurugram, Haryana 122002, India
| | - Sandeep Bhalla
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot 47, Sector 44, Gurugram, Haryana 122002, India
| | - Arun More
- Rural Health Progress Trust, Murud, Maharashtra 413510, India
| | - Mansi Patil
- Indian Association of Parenteral and Enteral Nutrition - Pune Chapter, Pune, Maharashtra 411019, India
| | - Amit Gupta
- Promhex Multispecialty Hospital Sector P-2, Omega 1, Greater Noida, Uttar Pradesh, India
| | - Bal Kishen Gupta
- S.P. Medical College & A.G. of Hospitals, Bikaner, Rajasthan, India
| | | | - Priyanka Gupta
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot 47, Sector 44, Gurugram, Haryana 122002, India
| | - Nikki Pandey
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot 47, Sector 44, Gurugram, Haryana 122002, India
| | - Vishal Patil
- Indian Association of Parenteral and Enteral Nutrition - Pune Chapter, Pune, Maharashtra 411019, India
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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27
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Twumasi-Ankrah B, Myers-Hansen GA, Adu-Boakye Y, Tannor EK, Nyarko OO, Boakye E, Lincoln MD, Quarshie GA, Deku EM, Galley ME, Beaney T, Ster AC, Xia X, Poulter N. May Measurement Month 2018: an analysis of blood pressure screening results from Ghana. Eur Heart J Suppl 2020; 22:H59-H61. [PMID: 32884472 PMCID: PMC7455267 DOI: 10.1093/eurheartj/suaa029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Elevated blood pressure (BP) is one of the leading risk factors for death and disability globally. It is also an important global health challenge because of its high prevalence and resulting morbidities. Albeit, a substantial number of people who have hypertension are either oblivious of it, not treated, or being managed but remain uncontrolled. May Measurement Month (MMM) is a global initiative led by the International Society of Hypertension (ISH) with the goal of increasing awareness of high BP and serving as a spur to establish screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Measurement of BP and collection of relevant health information were performed according to a standardized protocol for MMM. Screening sites were set up in churches, mosques, health facilities, pharmacies, recreational parks, sports facilities, shopping centres, marketplaces, universities, workplaces, and community centres across four regions of Ghana. A total of 6907 participants were screened during MMM 2018. After multiple imputation, 2354 (34.1%) had hypertension. Of individuals not taking antihypertensive medications 1526 (25.1%) were hypertensive of whom 48.4% were aware of having it. Also, of individuals taking antihypertensive medications 432 (52.2%) had uncontrolled BP. Data obtained from this project demonstrates that a significant number of people with hypertension are unaware of having it, are untreated, or are on treatment but remain uncontrolled. It also highlights the effectiveness of BP screening campaigns as a tool to identify persons with elevated BP.
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Affiliation(s)
| | - Gustavus A Myers-Hansen
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
- University of Ghana, Accra, Ghana
| | - Yaw Adu-Boakye
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | | | | | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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28
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Alcocer L, Chavez A, Gomez-Alvarez E, Espinosa C, Pombo J, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Mexico. Eur Heart J Suppl 2020; 22:H89-H91. [PMID: 32884481 PMCID: PMC7455279 DOI: 10.1093/eurheartj/suaa036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In 2015, arterial hypertension was responsible for 18.1% of the total deaths in Mexico and its mortality rate has increased to 29.9% in the last 6 years. It is currently the main risk factor for preventable premature deaths of adults in the country. Good quality epidemiological information is the first step to improve health services. May Measurement Month 2018 (MMM18) in Mexico is an opportunistic survey, which follows the previously published methodology. MMM18 included screening 10 139 participants, 2187 (21.6%) of whom were classified as having hypertension. Of these, 42.0% were aware of the condition before measurement, and 38.0% were on medication, of which 66.5% were controlled. Hence, of all hypertensive patients, 25.3% were controlled (<140/90 mmHg). MMM18 in Mexico provides complementary data to the existing information on arterial hypertension in the country and helps to increase the visibility of hypertension: a priority health problem.
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Affiliation(s)
- Luis Alcocer
- Instituto Mexicano de Salud Cardiovascular, Tuxpan 16, Cuauhtemoc, Mexico City 06760, Mexico
| | - Adolfo Chavez
- Centro Médico Nacional Siglo XXI, IMSS, Avenida Cuauhtemoc 330, Mexico City 06720, Mexico
| | - Enrique Gomez-Alvarez
- Centro Medico Nacional, 20 de Noviembre, ISSSTE, Felix Cuevas 540, Mexico City 03100, Mexico
| | - Cutberto Espinosa
- CENAPRECE (Centro Nacional de Programas Preventivos y Control de Enfermedades), Benjamín Franklin 132, Mexico City 11800, Mexico
| | - Jose Pombo
- Instituto del Corazón Queretaro, Privada Ignacio Zaragoza 16-B, Centro, Santiago de Queretaro 76000, Mexico
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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29
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Adhikari TB, Bhattarai H, Ranabhat K, Khanal P, Mishra SR, Koirala S, Pandey S, Devkota S, Gairhe M, Dhamala B, Soti PB, Paudel S, Lohani G, Koirala B, Beaney T, Ster AC, Poulter NR, Neupane D. May Measurement Month 2018: an analysis of blood pressure screening results from Nepal. Eur Heart J Suppl 2020; 22:H92-H95. [PMID: 32884482 PMCID: PMC7455271 DOI: 10.1093/eurheartj/suaa037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Raised blood pressure (BP) is a leading risk factor for mortality globally and in Nepal. May Measurement Month (MMM) is a global initiative aimed at screening for hypertension and raising awareness on high BP worldwide. This study provides the results of the 2018 MMM (MMM18) in Nepal. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018 nationwide. The standard MMM protocol was followed for BP measurement, the definition of hypertension, and statistical analysis. The campaign was publicized through various social media for recruiting volunteers and inviting participation. A total of 15 561 (58.7% male) from 35 districts of Nepal were screened in MMM18, of which 4 321 (27.8%) had hypertension. A total of 2 633 (19.0%) of 13 873 individuals who were not on antihypertensive treatment were found to be hypertensive. Of those on medication, 799 (47.4%) had uncontrolled BP. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in people on antihypertensive treatment, smokers, and alcohol drinkers compared with those who were not on antihypertensive treatment, smokers, and alcohol drinkers, respectively. Likewise, SBP and DBP steadily increased across increasing body mass index categories. MMM18 was the largest BP screening campaign undertaken in Nepal. MMM has highlighted the importance of a periodic public health program at the national level to increase awareness on hypertension detection and control rate, and thus, the prevention of cardiovascular diseases.
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Affiliation(s)
- Tara Ballav Adhikari
- COBIN Project, Nepal Development Society, Bharatpur 10, Chitwan, Nepal
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Kamal Ranabhat
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Pratik Khanal
- COBIN Project, Nepal Development Society, Bharatpur 10, Chitwan, Nepal
| | - Shiva Raj Mishra
- COBIN Project, Nepal Development Society, Bharatpur 10, Chitwan, Nepal
| | - Sweta Koirala
- COBIN Project, Nepal Development Society, Bharatpur 10, Chitwan, Nepal
| | - Sadhna Pandey
- Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Surya Devkota
- Manamohan Memorial Institute of Health Science, Kathmandu, Nepal
| | - Milan Gairhe
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bimala Dhamala
- Maharjgunj Nursing Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Pabitra Babu Soti
- COBIN Project, Nepal Development Society, Bharatpur 10, Chitwan, Nepal
| | - Sandip Paudel
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Gunaraj Lohani
- Maharjgunj Nursing Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bhagawan Koirala
- Manamohan Memorial Institute of Health Science, Kathmandu, Nepal
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W127RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Department of Health Service, Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
| | - Neil R Poulter
- Department of Health Service, Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
| | - Dinesh Neupane
- COBIN Project, Nepal Development Society, Bharatpur 10, Chitwan, Nepal
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Lanas F, Garcia MS, Paccot M, Peña J, Torres P, Beaney T, Ster AC, Poulter NR, Xia X. May Measurement Month 2018: an analysis of blood pressure screening results from Chile. Eur Heart J Suppl 2020; 22:H37-H39. [PMID: 32884465 PMCID: PMC7455284 DOI: 10.1093/eurheartj/suaa023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Fernando Lanas
- Departamento de Medicina Interna,Facultad de Medicina, Universidad de La Frontera, M Mont 112, Temuco 4780000, Chile
| | - Maria Soledad Garcia
- Cardiovascular Diseases Program, Supervisor Physician, Servicio de Salud Araucanía Sur, Arturo Prat 969, Temuco 4780000, Chile
| | - Melanie Paccot
- Chair Department of Non-Communicable Disease, Ministerio de Salud de Chile, Enrique Mac Iver 541, Santiago, Región Metropolitana 8320064, Chile
| | - Jimena Peña
- Consultorio Miraflores, Miraflores 1369, Temuco 4780000, Chile
| | - Pamela Torres
- Departamento de Salud Municipal, Valentin Letelier 415, Villarrica 4930000, Chile
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Chia YC, Ching SM, Devaraj NK, Chew BN, Ooi PB, Mohamed M, Othman AS, Kang PS, Husin HS, Mohamad Gani AH, Hamid D, Beaney T, Ster AC, Poulter NR, Xia X. May Measurement Month 2018: an analysis of blood pressure screening results from Malaysia. Eur Heart J Suppl 2020; 22:H83-H85. [PMID: 32884479 PMCID: PMC7455260 DOI: 10.1093/eurheartj/suaa035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Hypertension continues to be the top global killer, contributing to over 10 million deaths annually. As prevalence and unawareness of hypertension remain high in Malaysia, this study was aimed to screen more individuals to identify those with undiagnosed hypertension. Respondents aged ≥18 years were recruited through opportunistic sampling at various screening sites including health clinics, hospitals, student health centres, universities, community halls, shopping malls, as well as through other health screening campaigns. Each respondent completed a questionnaire on socio-demographic, environmental, and lifestyle data. Anthropometric measurements as well as three blood pressure (BP) measurements were obtained from all participants. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medication. The total number of participants was 4866. The mean age of the participants was 39.8 (17.6) years with 61.1% female participants. Of the 4866 participants, 1405 (28.9%) had hypertension. The proportion of those aware of their hypertension status was 76.3% (1073/1405). The proportion of those with hypertension on medication was 71% (998/1405). Of those receiving antihypertensive treatment, 62.4% (623/998) had controlled BP. The proportion of hypertension in this study was 28.9%. The awareness rate of 76.3% compares favourably to a previously reported national level of 43.2%. Hence, BP screening programmes may be effective at increasing awareness and should be conducted annually.
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Affiliation(s)
- Yook Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 5 Jalan University, Bandar Sunway, 47500 Selangor Darul Ehsan, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Bee Nah Chew
- Staff Health Unit, University of Malaya Medical Centre, Jalan Universiti, Lembah Pantai, 59100 Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Pei Boon Ooi
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 5 Jalan University, Bandar Sunway, 47500 Selangor Darul Ehsan, Malaysia
| | - Mohazmi Mohamed
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia
| | - Azli Shahril Othman
- Faculty of Medicine, Cyberjaya University College of Medical Sciences, Persiaran Bestari, Cyber 11, 63000 Cyberjaya, Selangor, Malaysia
| | - Pei San Kang
- Gopeng Government Health Clinic, Jalan Lawan Kuda Baru, 31600 Gopeng, Perak, Malaysia
| | - Hanis Saadah Husin
- Department of Primary Care, International Medical School, Management & Science University, University Drive, Off Persiaran Olahraga, 40100 Shah Alam, Selangor, Malaysia
| | - Abdul Hafiz Mohamad Gani
- Mahmmoodiah Government Health Clinic, JKR 6274, Jalan Mahmoodiah, 80000 Johor Bahru, Johor, Malaysia
| | - Dalyana Hamid
- AU2 Keramat Government Health Clinic, Jalan AU 2a, Taman Sri Keramat, 54200 Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Dzudie A, Njume E, Boombhi J, Awungia A, Ndom MS, Ebasone PV, Djomou A A, Ba H, Mfekeu LK, Menanga A, Kamdem F, Xia X, Ster AC, Beaney T, Poulter N, Kingue S. May Measurement Month 2018: blood pressure screening results in Cameroon. Eur Heart J Suppl 2020; 22:H33-H36. [PMID: 32884464 PMCID: PMC7455289 DOI: 10.1093/eurheartj/suaa019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
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.
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Affiliation(s)
- Anastase Dzudie
- Cameroon Cardiac Society, Cameroon
- Clinical Research Education, Networking and Consultancy, PO Box 3480, Douala, Cameroon
| | - Epie Njume
- Clinical Research Education, Networking and Consultancy, PO Box 3480, Douala, Cameroon
| | | | - Alexis Awungia
- Clinical Research Education, Networking and Consultancy, PO Box 3480, Douala, Cameroon
| | | | - Peter Vanes Ebasone
- Clinical Research Education, Networking and Consultancy, PO Box 3480, Douala, Cameroon
| | - Armel Djomou A
- Cameroon Cardiac Society, Cameroon
- Fondation Coeur et Vie, Douala, Cameroon
| | | | | | | | | | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Neil Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Božič N, Knez J, Dolenc P, Salobir B, Erhartič A, Čegovnik B, Brus I, Petek Šter M, Hlastan Ribič C, Beaney T, Ster AC, Xia X, Poulter NR, Brguljan Hitij J. May Measurement Month 2018: an analysis of blood pressure screening results from Slovenia. Eur Heart J Suppl 2020; 22:H112-H114. [PMID: 32884487 PMCID: PMC7455269 DOI: 10.1093/eurheartj/suaa042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
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.
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Affiliation(s)
- Nina Božič
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
| | - Judita Knez
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
| | - Primož Dolenc
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
| | - Barbara Salobir
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
| | - Andrej Erhartič
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
| | - Borut Čegovnik
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
| | - Ivanka Brus
- Slovenian Chamber of Pharmacies, Vojkova cesta 48, Ljubljana 1000, Slovenia
| | - Marija Petek Šter
- Slovenian Medical Association, Slovenian Family Medicine Society, Dunajska cesta 162, Ljubljana 1000, Slovenia
- Trebnje Health Center, Goliev trg 3, Trebnje 8210, Slovenia
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Poljanski nasip 58, Ljubljana 1000, Slovenia
| | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Jana Brguljan Hitij
- Division of Internal Medicine, Department of Hypertension, University Medical Centre Ljubljana, Dr Peter Držaj Hospital, Vodnikova cesta 62, Ljubljana 1000, Slovenia
- Slovenian Hypertension Society, Dunajska cesta 162, Ljubljana, 1000 Slovenia
- Department of Internal Medicine, Medical Faculty, University of Ljubljana, Zaloška cesta 7, Ljubljana 1000, Slovenia
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Lin HJ, Pan HY, Beaney T, Ster AC, Poulter NR, Chen WJ, Wang TD. May Measurement Month 2018: an analysis of blood pressure screening results from Taiwan. Eur Heart J Suppl 2020; 22:H125-H127. [PMID: 32884491 PMCID: PMC7455295 DOI: 10.1093/eurheartj/suaa087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
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.
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Affiliation(s)
- Hung-Ju Lin
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan
| | - Heng-Yu Pan
- Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Taipei City 64041, Taiwan
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Wen-Jone Chen
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan
| | - Tzung-Dau Wang
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan
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Beaney T, Ster AC, Poulter NR, Xia X, Fageh H, Msalam O, Derbi HA, Osman AM, Aghilla M, Bettamer ZA, Fhail Alboum MO, Elsari OT, Elhemali EM, Zidan RA, Musbah A, Eltawell H, Ben Masaud HA. May Measurement Month 2018: an analysis of blood pressure screening in Libya. Eur Heart J Suppl 2020; 22:H77-H79. [PMID: 32884477 PMCID: PMC7456182 DOI: 10.1093/eurheartj/suaa011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Elevated blood pressure (BP) is an important public health concern and leads to several adverse cardiovascular outcomes. In the stepwise survey done in Libya by the Libyan Cardiac Society and National Centre for Disease Control in 2009, the percentage of hypertension was 40.6%. To raise awareness of high BP and to highlight the size of the problem and the need for screening. A cross-sectional opportunistic study included men and women aged ≥18 years. Blood pressure was measured three times and a questionnaire was completed. Hypertension was defined as BP ≥140/90 mmHg based on the mean of the 2nd and 3rd readings, or on antihypertensive treatment. Among 7279 participants, the mean age was 44.3 ± 14.8 years, 57.8% male, 2567 (35.3%) of the participants had hypertension of whom 63.4% were aware of having hypertension, 55.8% on medication, and of those on medication 50.9% had controlled BP. This survey identified a high proportion of individuals with high BP, which highlights the need for a more strategic approach to fighting hypertension.
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Affiliation(s)
- Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Hatem Fageh
- Cardiovascular Medicine Department, Tripoli University Hospital, Faculty of Medicine, Hypertension Working Group, Libyan Cardiac Society, Aeen Zarra, Alfornaj, Tripoli, Libya
| | - Omar Msalam
- Cardiovascular Medicine Department, Almostakbal Almoshrek Clinic, Prevention Working Group, Libyan Cardiac Society (LCS), Aeen Zarra, Alfornaj, Tripoli, Libya
| | - Hawa A Derbi
- Cardiology Department, Tripoli University Hospital, LCS, Aeen Zarra, Alfornaj, Tripoli, Libya
| | - Afaf M Osman
- Noncommunicable Disease Department, National Center for Disease Control (NCDC), Aeen Zarra, Tripoli, Libya
| | - Mohamed Aghilla
- Noncommunicable Disease Department, National Center for Disease Control (NCDC), Aeen Zarra, Tripoli, Libya
| | - Zaki A Bettamer
- Cardiology Department Libyan, International University, Aljamhouria Hospital, LCS, Benghazi, Libya
| | | | - Osama T Elsari
- Radiology Department, Zliten Teaching Hospital, Zliten, Libya
| | | | | | | | - Hazem Eltawell
- Noncommunicable Disease Department, National Center for Disease Control (NCDC), Aeen Zarra, Tripoli, Libya
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Rodilla E, Molinero A, Gijón-Conde T, Tous S, Fornós JA, Mera I, Martínez F, Carreras B, de Berardinis B, Beaney T, Ster AC, Poulter NR, Xia X, Ruilope LM. May Measurement Month 2018: an analysis of blood pressure screening results from Spain. Eur Heart J Suppl 2020; 22:H119-H121. [PMID: 32884489 PMCID: PMC7455258 DOI: 10.1093/eurheartj/suaa044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Enrique Rodilla
- Internal Medicine, University Hospital Sagunto, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Luis Vives, 1 Alfara del Patriarca, Valencia 46115, Spain
| | - Ana Molinero
- Spanish Society of Community and Family Pharmacy, Paseo de las Delicias, 31 – Esc. Izq. 4º Dcha., Madrid 28045, Spain
| | - Teresa Gijón-Conde
- Primary Care Center Cerro del Aire, Majadahonda, Council of the Spanish Society of Hypertension, Av. de España, 7, 28220 Majadahonda, Madrid, Spain
| | - Salvador Tous
- Spanish Society of Community and Family Pharmacy, Paseo de las Delicias, 31 – Esc. Izq. 4º Dcha., Madrid 28045, Spain
| | - José A Fornós
- Spanish Society of Community and Family Pharmacy, Paseo de las Delicias, 31 – Esc. Izq. 4º Dcha., Madrid 28045, Spain
| | - Inés Mera
- Spanish Society of Community and Family Pharmacy, Paseo de las Delicias, 31 – Esc. Izq. 4º Dcha., Madrid 28045, Spain
| | - Fernando Martínez
- Hypertension Unit, Polytechnic University Hospital La Fe, University of Valencia, Avinguda de Fernando Abril Martorell, 106, Valencia 46026, Spain
| | - Blanca Carreras
- Internal Medicine, University Hospital Sagunto, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Luis Vives, 1 Alfara del Patriarca, Valencia 46115, Spain
| | - Bettina de Berardinis
- Internal Medicine, University Hospital Sagunto, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Luis Vives, 1 Alfara del Patriarca, Valencia 46115, Spain
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Luis M Ruilope
- Instituto de Investigación Hospital 12 de Octubre, Universidad Europea de Madrid, Madrid, Spain
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Turana Y, Widyantoro B, Situmorang TD, Delliana J, Roesli RMA, Danny SS, Suhardjono, Sofiatin Y, Hermiawaty E, Kuncoro AS, Barack R, Beaney T, Ster AC, Poulter NR, Santoso A. May Measurement Month 2018: an analysis of blood pressure screening results from Indonesia. Eur Heart J Suppl 2020; 22:H66-H69. [PMID: 32884474 PMCID: PMC7455301 DOI: 10.1093/eurheartj/suaa031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardio-cerebro-reno-vascular morbidity and mortality. For the second year of the May Measurement Month (MMM) campaign in Indonesia in 2018, we recruited 174 sites in 31 out of 34 provinces in Indonesia and screened through convenience sampling in public areas and rural primary health centres. Hypertension was defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or both, or on the basis of receiving antihypertensive medication. Blood pressure was measured three times followed the standard global MMM protocol, multiple imputation was used to estimate the mean of the 2nd and 3rd BP readings if these were not recorded. A total of 91 222 individuals were screened, and after multiple imputations, 27 331 (30.0%) had hypertension. Of individuals not receiving antihypertensive medication, 14 367 (18.4%) were hypertensive. Among the 47.4% of hypertensive individuals on antihypertensive medication, 10 106 (78.0%) had uncontrolled BP. MMM17 and MMM18 were still the most extensive standardized screening campaigns for BP measurement in Indonesia. Compared to the previous study, the proportion with uncontrolled BP on medication was significantly higher and provided the substantial challenges in managing hypertension in the rural community.
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Affiliation(s)
- Yuda Turana
- Department of Neurology, School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta 14440, Indonesia
| | - Bambang Widyantoro
- Department of Cardiology — Vascular Medicine, Faculty of Medicine, Universitas Indonesia — National Cardiovascular Center Harapan Kita Hospital, Jl. S. Parman Kav 87, Slipi, Jakarta 11420, Indonesia
| | - Tunggul D Situmorang
- Division of Nephrology, Department of Internal Medicine, PGI Cikini Hospital, Jakarta 10330, Indonesia
| | - Juzi Delliana
- Department of Cardiology, Directorate of Non-Communicable Disease, Ministry of Health - Republic of Indonesia, Jalan Percetakan Negara 29, Jakarta 10560, Indonesia
| | - Rully M A Roesli
- Department of Internal Medicine, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital, Bandung 40161, Indonesia
| | - Siska S Danny
- Department of Cardiology — Vascular Medicine, Faculty of Medicine, Universitas Indonesia — National Cardiovascular Center Harapan Kita Hospital, Jl. S. Parman Kav 87, Slipi, Jakarta 11420, Indonesia
| | - Suhardjono
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo National General Hospital, Jalan Pangeran Diponegoro No: 71, Jakarta 10430, Indonesia
| | - Yulia Sofiatin
- Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Prof. Eijkman 38, Bandung 40161, Indonesia
| | - Eka Hermiawaty
- Department of Neurology, National Cardiovascular Center Harapan Kita Hospital, Jl. S. Parman Kav 87, Slipi, Jakarta 11420, Indonesia
| | - Ario S Kuncoro
- Department of Cardiology — Vascular Medicine, Faculty of Medicine, Universitas Indonesia — National Cardiovascular Center Harapan Kita Hospital, Jl. S. Parman Kav 87, Slipi, Jakarta 11420, Indonesia
| | - Rossana Barack
- Department of Cardiology, MMC Hospital, Jakarta, Indonesia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, Shepherd's Bush, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, Shepherd's Bush, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, Shepherd's Bush, London W12 7RH, UK
| | - Anwar Santoso
- Department of Cardiology — Vascular Medicine, Faculty of Medicine, Universitas Indonesia — National Cardiovascular Center Harapan Kita Hospital, Jl. S. Parman Kav 87, Slipi, Jakarta 11420, Indonesia
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Barbosa E, Eibel B, Feitosa ADM, Brandão AA, Bortolotto LA, Neves MFT, Martin JFV, Spinelli ACS, Cestário EES, Campana EMG, Toledo JCY, Póvoa RMS, Beaney T, Ster AC, Poulter NR, Mota-Gomes MA, Barroso WKS. May Measurement Month 2018: an analysis of blood pressure screening results from Brazil. Eur Heart J Suppl 2020; 22:H26-H29. [PMID: 32884462 PMCID: PMC7455292 DOI: 10.1093/eurheartj/suaa022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
| | - Bruna Eibel
- Hypertension League, Porto Alegre, Brazil
- Post Graduation Program IC/FUC, Porto Alegre, Brazil
| | - Audes D M Feitosa
- Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco, Recife, Brazil
| | | | | | - Mario F T Neves
- Department of Clinical Medicine State, University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - José F V Martin
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São Paulo, Brazil
| | | | | | - Erika M G Campana
- Universidade Nova Iguaçu (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Juan C Y Toledo
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São Paulo, Brazil
| | - Rui M S Póvoa
- Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Marco A Mota-Gomes
- Department of Cardiology, CESMAC/Uncisal, Hospital do Coração de Alagoas, Maceió, Brazil
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Ellenga Mbolla BF, Kouala Landa CM, Bakekolo PR, Makani Bassakouahou JK, Bouithy SN, Eyeni-Sinomono T, Bianza JR, Ossou-Nguiet PM, Bani AM, Kimpamboudi A, Beaney T, Ster AC, Poulter NR, Xia X, Kimbally Kaky SG. May Measurement Month 2018: an analysis of blood pressure screening results from Republic of the Congo. Eur Heart J Suppl 2020; 22:H47-H49. [PMID: 32884468 PMCID: PMC7455256 DOI: 10.1093/eurheartj/suaa026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Bertrand F Ellenga Mbolla
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Christian M Kouala Landa
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Paterne R Bakekolo
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Jospin K Makani Bassakouahou
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Sabrina N Bouithy
- Reference Hospital of Talangai, n°35 Avenue des 3 martyrs, Talangaï District, Brazzaville, Republic of the Congo
| | - Tony Eyeni-Sinomono
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Jean-R Bianza
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Paul-M Ossou-Nguiet
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
| | - Aloise M Bani
- General Hospital of Loandjili, Route n°1, BP 8122, Pointe-Noire, Republic of the Congo
| | - Aubierge Kimpamboudi
- Head of Social and Health District from Pointe-Noire, Pointe-Noire, Republic of the Congo
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Suzy-G Kimbally Kaky
- Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, n°1 Avenue des 1er Jeux Africains, Brazzaville, Republic of the Congo
- University Teaching Hospital of Brazzaville, n°13 bd Auxence Ikonga, BP 32, Brazzaville, Republic of the Congo
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Lopez-Jaramillo P, Otero J, Alvernia J, Ney-Salazar D, Lopez-Lopez J, Accini JL, Aroca G, Urina-Triana M, Sánchez-Vallejo G, Arcos E, Casanova ME, García H, Beaney T, Ster AC, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Colombia. Eur Heart J Suppl 2020; 22:H43-H46. [PMID: 32884467 PMCID: PMC7455303 DOI: 10.1093/eurheartj/suaa025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
- Patricio Lopez-Jaramillo
- Instituto de Investigaciones Masira, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Lagos del Cacique, Bucaramanga, Santander, Colombia
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Calle 155 A 23 04, El Bosque, Floridablanca, Santander, Colombia
| | - Johanna Otero
- Instituto de Investigaciones Masira, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Lagos del Cacique, Bucaramanga, Santander, Colombia
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Calle 155 A 23 04, El Bosque, Floridablanca, Santander, Colombia
| | - Juliana Alvernia
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Calle 155 A 23 04, El Bosque, Floridablanca, Santander, Colombia
| | - Daniela Ney-Salazar
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Calle 155 A 23 04, El Bosque, Floridablanca, Santander, Colombia
| | - Jose Lopez-Lopez
- Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Calle 155 A 23 04, El Bosque, Floridablanca, Santander, Colombia
| | - Jose L Accini
- IPS Centro Científico Asistencial, Carrera 43b #80-101, Barranquilla, Atlántico, Colombia
- Unidad de cuidados críticos, Facultad de Medicina Universidad Libre and Universidad del Norte, Km. 7 Antigua Vía Puerto Colombia, Barranquilla, Atlántico, Colombia
| | - Gustavo Aroca
- Facultad de Medicina, Universidad Simón Bolívar and Clínica de la Costa, Carrera 50 80-90, Barranquilla, Atlántico, Colombia
| | - Miguel Urina-Triana
- Facultad de Medicina, Universidad Simón Bolívar and Clínica de la Costa, Carrera 50 80-90, Barranquilla, Atlántico, Colombia
| | - Gregorio Sánchez-Vallejo
- Fundacion Centro de Obesidad y Metabolismo COMETA, Carrera 36 # 19–94 Barrio Palermo, Pasto, Colombia
| | - Edgar Arcos
- Programa de Medicina Interna, Universidad Libre, Carrera 37A #3-29 Cali, Colombia
| | - María E Casanova
- Departamento de Investigación Clínica, Fundación Centro de Investigaciones Biomédicas (RIESCARD), Carrera 5 #1870, El Espinal, Tolima, Colombia
| | - Henry García
- Departamento de Investigación Clínica, Fundación Centro de Investigaciones Biomédicas (RIESCARD), Carrera 5 #1870, El Espinal, Tolima, Colombia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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Chen X, Li Y, Hu Z, Liu M, Yu J, Wang HY, Xu LY, Zhou BR, Yu W, Li L, Tang GB, Beaney T, Ster AC, Poulter NR, Wang JG. May Measurement Month 2018: an analysis of blood pressure screening results from China. Eur Heart J Suppl 2020; 22:H40-H42. [PMID: 32884466 PMCID: PMC7455255 DOI: 10.1093/eurheartj/suaa024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Xin Chen
- Department of Hypertension, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Xiwang Road 999, Shanghai 201801, China
| | - Yan Li
- The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Ruijin 2nd Road 197, Shanghai 200025, China
| | - Zhe Hu
- Department of Hypertension, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Xiwang Road 999, Shanghai 201801, China
| | - Min Liu
- Department of Hypertension, Henan Provincial People’s Hospital, Weiwu Road 7, Zhengzhou 450003, Henan Province, China
| | - Jing Yu
- Department of Cardiology, Lanzhou University Second Hospital, Cuiyingmen 82, Lanzhou 730030, Gansu Province, China
| | - Hong-Yu Wang
- Department of Cardiology, Second Hospital of Shanxi Medical University, Wuyi Road 382, Taiyuan 030001, Shanxi Province, China
| | - Li-Ying Xu
- Department of Cardiology, Fourth People’s Hospital of Datong, Gongnong Road 16, Datong 037008, Shanxi Province, China
| | - Bi-Rong Zhou
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, Anhui Province, China
| | - Wei Yu
- Department of Cardiology, Zhejiang Hospital, Lingyin Road 12, Hangzhou 310013, Zhejiang Province, China
| | - Li Li
- Department of Cardiology, The Second Affiliated Hospital of Zhengzhou University, Jingba Road 2, Zhengzhou 450014, Henan Province, China
| | - Guo-Bao Tang
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Zhenhai Road 55, Xiamen 361003, Fujian Province, China
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Ji-Guang Wang
- Department of Hypertension, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Xiwang Road 999, Shanghai 201801, China
- The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Ruijin 2nd Road 197, Shanghai 200025, China
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Beheiry HM, Abdalla AA, Fahal NA, Mohamed MI, Ibrahim DA, Medani SA, Khalfa HA, Mutalab SA, Atia A, Elsheik WA, Khalfa RA, Mahmoud NE, Beaney T, Ster AC, Ali IA, Poulter NR. May Measurement Month 2018: an analysis of blood pressure screening results from Sudan. Eur Heart J Suppl 2020; 22:H122-H124. [PMID: 32884490 PMCID: PMC7456183 DOI: 10.1093/eurheartj/suaa045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
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.
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Affiliation(s)
- Hind M Beheiry
- Department of Physiology, International University of Africa, Khartoum, Sudan
| | - Asma A Abdalla
- Department of Community Medicine, University of Khartoum, Khartoum, Sudan
| | - Naiema A Fahal
- Federal Department of Community Medicine, AlMugtarbin University, Khartoum, Sudan
| | - Maha I Mohamed
- Department of Biochemistry, Elneelain University, Khartoum, Sudan
| | - Dina A Ibrahim
- Department of Biochemistry, Karari University, Khartoum, Sudan
| | - Safaa A Medani
- Department of Pediatrics, Elneelain University, Khartoum, Sudan
| | - Hana A Khalfa
- Department of Physiology, AlMugtarbin University, Khartoum, Sudan
| | | | - Amna Atia
- Department of Internal Medicine, Hag Al Safi Hospital, Bahri, Sudan
| | - Wigdan A Elsheik
- Department of Medicine, Zaiem Al Azhari University, Bahri, Sudan
| | - Rania A Khalfa
- Department of Medicine, Al Shaab Hospital, Khartoum, Sudan
| | - Nagla E Mahmoud
- Ministry of Health, Quality and Excellence Directorate, Riyadh, Saudi Arabia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, London, UK
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Ibtisam A Ali
- Department of Medicine, International University of Africa, Khartoum, Sudan
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, London, UK
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Hernández-Hernández R, Duín A, Octavio-Seijas JA, López-Rivera J, Morr I, Silva E, Gúzman-Franolic ML, Costantini-Olmos AP, Marval J, Ruíz-Lugo JF, Vásquez D, Méndez-Amaya NC, Armas-Hernández MJ, Beaney T, Ster AC, Poulter NR. Results of May Measurement Month 2018 campaign in Venezuela. Eur Heart J Suppl 2020; 22:H135-H138. [PMID: 32884494 PMCID: PMC7455277 DOI: 10.1093/eurheartj/suaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Rafael Hernández-Hernández
- Hypertension and Cardiovascular Risk Factors Clinic, School of Medicine, Universidad Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela
| | - Amanda Duín
- Hypertension and Cardiovascular Risk Factors Clinic, School of Medicine, Universidad Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela
| | | | | | - Igor Morr
- Department of Experimental Cardiology. Tropical Medicine Institute, Universidad Central de Venezuela
| | - Egle Silva
- Instituto de Investigaciones de Enfermedades Cardiovasculares de LUZ. Universidad del Zulia, Maracaibo, Venezuela
| | | | | | - José Marval
- Venezuelan Society of Cardiology and Venezuelan Society of Hypertension
| | | | - Dámaso Vásquez
- Venezuelan Society of Cardiology and Venezuelan Society of Hypertension
| | | | - Maria J Armas-Hernández
- Hypertension and Cardiovascular Risk Factors Clinic, School of Medicine, Universidad Centro Occidental Lisandro Alvarado, Barquisimeto, Venezuela
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
- Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
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