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- Beaney, Thomas, et al.
(author)
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May Measurement Month 2018 : a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension
- 2019
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In: European Heart Journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 40:25, s. 2006-2017
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Journal article (peer-reviewed)abstract
- AIMS: Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. METHODS AND RESULTS: Eighty-nine countries 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 or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. CONCLUSION: May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk.
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2. |
- Beaney, Thomas, et al.
(author)
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May measurement month 2019 : The global blood pressure screening campaign of the international society of hypertension
- 2020
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In: Hypertension. - 0194-911X. ; 76:2, s. 333-341
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Journal article (peer-reviewed)abstract
- Elevated blood pressure remains the single biggest risk factor contributing to the global burden of disease and mortality. May Measurement Month is an annual global screening campaign aiming to improve awareness of blood pressure at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at sites in 92 countries during May 2019. Ideally, 3 blood pressure readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg (mean of the second and third readings) or taking antihypertensive medication. When necessary, multiple imputation was used to estimate participants' mean blood pressure. Mixed-effects models were used to evaluate associations between blood pressure and participant characteristics. Of 1 508 130 screenees 482 273 (32.0%) had never had a blood pressure measurement before and 513 337 (34.0%) had hypertension, of whom 58.7% were aware, and 54.7% were on antihypertensive medication. Of those on medication, 57.8% were controlled to <140/90 mm Hg, and 28.9% to <130/80 mm Hg. Of all those with hypertension, 31.7% were controlled to <140/90 mm Hg, and 350 825 (23.3%) participants had untreated or inadequately treated hypertension. Of those taking antihypertensive medication, half were taking only a single drug, and 25% reported using aspirin inappropriately. This survey is the largest ever synchronized and standardized contemporary compilation of global blood pressure data. This campaign is needed as a temporary substitute for systematic blood pressure screening in many countries worldwide.
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- Lin, Queran, et al.
(author)
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Hypertension in stroke survivors and associations with national premature stroke mortality : data for 2·5 million participants from multinational screening campaigns
- 2022
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In: The Lancet Global Health. - 2214-109X. ; 10:8, s. 1141-1149
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Journal article (peer-reviewed)abstract
- Background: Blood pressure control has a pivotal role in reducing the incidence and recurrence of stroke. May Measurement Month (MMM), which was initiated in 2017 by the International Society of Hypertension, is the largest global blood pressure screening campaign. We aim to compare MMM participants with and without a previous history of stroke and to investigate associations between national-level estimates of blood pressure management from MMM and premature stroke mortality. Methods: In this annual, global, cross-sectional survey, more than 2·5 million volunteers (≥18 years) from 92 countries were screened in May, 2017, and May, 2018. Three seated blood pressure readings and demographic, lifestyle, and cardiovascular disease data were collected. Associations between risk factors and stroke history were analysed with mixed-effects logistic regression, and associations between national-level estimates of blood pressure management and premature stroke mortality based on Global Burden of Disease data were investigated with linear regression. Findings: 2 222 399 (88·4%) of 2 515 365 participants had recorded data on a history of stroke, of whom 62 639 (2·8%) reported a previous stroke. Participants with a history of stroke had higher rates of hypertension (77·0% vs 32·9%, p<0·0001) and of treated (90·2% vs 57·0%, p<0·0001) and controlled (55·9% vs 32·4%, p<0·0001) hypertension than those without a history of stroke. A third of participants with a history of stroke had either untreated hypertension or treated but uncontrolled hypertension (blood pressure ≥140/90 mm Hg). Strong positive associations were found between national premature stroke mortality and mean systolic blood pressure (84·3 [95% CI 38·8 to 129·9] years of life lost [YLL] per 100 000 people per mm Hg increase) and the percentage of participants with raised blood pressure (49·1 [22·6 to 75·6] YLL per 100 000 people per 1% increase). Strong negative associations were found between national premature stroke mortality and the percentage of participants with hypertension on treatment (−21·0 [−33·0 to −8·9] YLL per 100 000 people per 1% increase) and with controlled blood pressure (−31·6 [−43·8 to −19·4] YLL per 100 000 people per 1% increase). Interpretation: Blood pressure control remains suboptimal worldwide among people with a history of stroke. National estimates of blood pressure management reflect national premature stroke mortality sufficiently to prompt policy makers to promote blood pressure screening and management. Funding: International Society of Hypertension and Servier Pharmaceuticals.
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