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May Measurement Month 2018: an analysis of blood pressure screening in the Philippines
Rafael R Castillo1,2, Leilani B Mercado-Asis3, Alberto A Atilano4
1Section of Cardiology, Department of Internal Medicine, Manila Doctors Hospital, 667 United Nations Avenue, Ermita, Manila 1000, Philippines.
Insights
May Measurement Month 2018 screened over 177,000 individuals in the Philippines, identifying high blood pressure (hypertension) in 39%. Opportunistic screening effectively detects unaware hypertensive individuals for treatment.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- May Measurement Month (MMM) is a global initiative to raise awareness of high blood pressure (hypertension).
- The Philippine Society of Hypertension participated in MMM18 to continue efforts from MMM17.
- Uncontrolled hypertension remains a significant public health concern globally and in the Philippines.
Purpose of the Study:
- To assess the prevalence of hypertension in the Philippines through opportunistic screening during MMM18.
- To identify unaware hypertensive individuals and facilitate their referral for treatment.
- To evaluate the effectiveness of opportunistic blood pressure screening as a public health strategy.
Main Methods:
- The study followed the International Society of Hypertension's standard MMM18 protocol.
- Convenience sampling was used with volunteer investigators screening adult volunteers (≥18 years).
- Three sitting blood pressure measurements were taken, along with demographic, lifestyle, and environmental data for 177,176 participants.
Main Results:
- 39.0% of screened individuals were hypertensive. Of these, 50.3% were aware of their condition, and 49.9% were on medication.
- Only 28.9% of all hypertensive participants had controlled blood pressure (<140/90 mmHg).
- Higher blood pressure levels were observed in overweight/obese individuals, those on medication, and patients with diabetes; lower levels were seen in pregnant women.
Conclusions:
- Opportunistic blood pressure screening, utilizing volunteers, is a pragmatic public health measure.
- MMM18 demonstrated the continued value of this approach in improving hypertension awareness and treatment rates in the Philippines.
- Further efforts are needed to improve blood pressure control rates among diagnosed hypertensive individuals.
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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