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May Measurement Month 2017: screening for hypertension in Nigeria-Sub-Saharan Africa

Okechukwu Samuel Ogah1, Ayodeji Arije1, Xia Xin2

  • 1Department of Medicine, University College Hospital/University of Ibadan, Nigeria.

European Heart Journal Supplements : Journal of the European Society of Cardiology
|May 3, 2019
PubMed

Insights

High blood pressure (hypertension) affects over a third of Nigerians, with many unaware or undertreated. Opportunistic screening identified significant numbers with undiagnosed or uncontrolled hypertension.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Hypertension is a leading cause of emergency admissions, stroke, heart failure, kidney disease, and dementia in Nigeria.
  • Low awareness, treatment, and control rates of hypertension are critical global and national health concerns.
  • The International Society of Hypertension's May Measurement Month (MMM) initiative addresses the lack of worldwide blood pressure screening programs.

Purpose of the Study:

  • To assess the prevalence of hypertension and its control status in Nigeria.
  • To evaluate the effectiveness of opportunistic screening in identifying individuals with raised blood pressure.
  • To contribute data to the global May Measurement Month (MMM) initiative.

Main Methods:

  • An opportunistic cross-sectional survey conducted in May 2017 (MMM17) screened 19,904 volunteers aged 18 years and above.
  • Standard MMM protocols were followed for blood pressure measurement, hypertension definition, and statistical analysis.
  • Multiple imputation was used to handle missing data, with a final sample size of 6709 analyzed for hypertension prevalence.

Main Results:

  • Overall, 36.2% of screened individuals had hypertension after multiple imputation.
  • Among those not on medication, 25.9% had hypertension, indicating a high rate of undiagnosed cases.
  • Of those on anti-hypertensive medication, 58.8% had uncontrolled blood pressure, highlighting treatment challenges.

Conclusions:

  • Opportunistic screening effectively identifies a significant number of individuals with previously undiagnosed or inadequately controlled hypertension in Nigeria.
  • The findings underscore the urgent need for improved hypertension awareness, screening, and management strategies in the country.
  • MMM17 demonstrated the value of large-scale screening campaigns in revealing the substantial burden of uncontrolled hypertension.

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