Imperial Clinical Trials Unit, and.
Department of Primary Care and Public Health, Imperial College London, London, UK.
J Hypertens. 2023 Sep 1;41(9):1446-1455. doi: 10.1097/HJH.0000000000003488. Epub 2023 Jun 19.
Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.
Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and clinical data. Hypertension was defined as a systolic BP at least 140 mmHg and/or a diastolic BP at least 90 mmHg (using the mean of the second and third readings) or taking antihypertensive medication. Multiple imputation was used to impute the average BP when readings were missing.
Of the 642 057 screenees, 225 882 (35.2%) were classified as hypertensive, of whom 56.8% were aware, and 50.3% were on antihypertensive medication. Of those on treatment, 53.9% had controlled BP (<140/90 mmHg). Awareness, treatment and control rates were lower than those reported in MMM campaigns before the COVID-19 pandemic. Minimal changes were apparent among those testing positive for, or being vaccinated against COVID-19. Of those on antihypertensive medication, 94.7% reported no change in their treatment because of the COVID-19 pandemic.
The high yield of untreated or inadequately treated hypertension in MMM 2021 confirms the need for systematic BP screening where it does not currently exist.
尽管发生了 COVID-19 大流行,血压升高(BP)仍然是导致全球疾病负担和死亡率的最大风险因素。五月测量月(MMM)是一项年度全球筛查活动,旨在通过评估高血压成年人的全球知晓率、治疗率和控制率,强调血压测量的重要性。2021 年,我们评估了 COVID-19 大流行期间这些比率的全球负担。
2021 年 5 月至 11 月在 54 个国家设立筛查点,通过方便抽样招募筛查对象。测量三次静坐血压,并完成包括人口统计学、生活方式和临床数据的问卷。高血压定义为收缩压至少 140mmHg 和/或舒张压至少 90mmHg(使用第二和第三次读数的平均值)或服用抗高血压药物。当读数缺失时,使用多重插补法来插补平均血压。
在 642057 名筛查对象中,225882 名(35.2%)被归类为高血压,其中 56.8%知晓,50.3%服用抗高血压药物。在接受治疗的人群中,53.9%的人血压得到控制(<140/90mmHg)。与 COVID-19 大流行前的 MMM 活动报告的结果相比,知晓率、治疗率和控制率较低。检测出 COVID-19 阳性或接种 COVID-19 疫苗的人群中,变化最小。在服用抗高血压药物的人群中,94.7%的人报告由于 COVID-19 大流行,他们的治疗没有改变。
在 2021 年 MMM 中,大量未经治疗或治疗不足的高血压患者证实,在目前没有系统进行血压筛查的地方,需要进行系统的血压筛查。