No abstract

No abstract

The World Health Organization goal's to reduce mortality due to chronic non-communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost-effective population interventions to reduce chronic non-communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese-speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment.

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 aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. Cabo Verde is in an epidemiological transition, with replacement of infectious diseases by chronic diseases, and the major cause of morbidity/mortality is cardiovascular disease which caused 28.9% of the total deaths in 2016. The only data we have are from 2007—the Ministry of Health and Social Security used a study STEP approach in which the prevalence of hypertension was 35%. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017 (MMM17). Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. A total of five islands and eight centres, including hospitals and local health centres participated in this study, with about 20 volunteers/investigators. A total of 2630 individuals were screened during MMM17. After multiple imputation, 760 (29.0%) had hypertension defined as being on BP lowering treatment or having a BP ≥140/90 mmHg. Of individuals not receiving anti-hypertensive medication, 232 (11.1%) were hypertensive. Of 522 individuals receiving anti-hypertensive medication with an available BP, 225 (43.1%) had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Cabo Verde. The proportion of hypertensives in the population in study was 29.0%, with most of these on treatment, and 43.1% of those on treatment with uncontrolled hypertension. These results suggest that opportunistic screening can identify significant numbers with raised BP.

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.