Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Our previous primary health surveys in 2013 and 2018 show that 25.8% to 34.1% of adults have raised BP, which is associated with cardiovascular, cerebrovascular, and renovascular morbidity and mortality. 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. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. We recruited 292 sites in all 34 provinces in Indonesia, and screened in public areas and offices as well as health centres. A total of 69 307 individuals were screened. After multiple imputation, 23 892 (34.5%) had hypertension. Of individuals not receiving antihypertensive medication, 20.0% were hypertensive. Among individuals receiving antihypertensive medication, 7885 (62.8%) had uncontrolled BP. MMM17 was the largest standardized screening campaign for BP measurement in our country. The proportion of individuals identified with hypertension and the percentage of those with uncontrolled BP on medication provide evidence of the substantial challenges in managing hypertension in the community. These results suggest that opportunistic screening can identify significant numbers of individuals with raised BP.
Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardio-cerebro-reno-vascular morbidity and mortality. For the second year of the May Measurement Month (MMM) campaign in Indonesia in 2018, we recruited 174 sites in 31 out of 34 provinces in Indonesia and screened through convenience sampling in public areas and rural primary health centres. Hypertension was defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or both, or on the basis of receiving antihypertensive medication. Blood pressure was measured three times followed the standard global MMM protocol, multiple imputation was used to estimate the mean of the 2nd and 3rd BP readings if these were not recorded. A total of 91 222 individuals were screened, and after multiple imputations, 27 331 (30.0%) had hypertension. Of individuals not receiving antihypertensive medication, 14 367 (18.4%) were hypertensive. Among the 47.4% of hypertensive individuals on antihypertensive medication, 10 106 (78.0%) had uncontrolled BP. MMM17 and MMM18 were still the most extensive standardized screening campaigns for BP measurement in Indonesia. Compared to the previous study, the proportion with uncontrolled BP on medication was significantly higher and provided the substantial challenges in managing hypertension in the rural community.
Background: Bone mineral disorders in chronic kidney disease (CKD-MBD) is one of the complications that occurs due to systemic disorders of minerals and bones in chronic kidney disease (CKD). This syndrome is one or a combination of laboratory abnormalities (phosphate, parathyroid hormone, and vitamin D), bone disorders (turnover, mineralization, volume, linear growth, and strength), and/ or vascular calcification or other soft tissue. It is associated with high mortality and morbidity in CKD patients. To determine the relationship of vitamin D levels and bone mineral density (BMD) examination with the hemodialysis vintage in CKD patients undergoing hemodialysis at RSUD Dr. Zainoel Abidin. Methods: This study is a cross-sectional study held in Zainoel Abidin Hospital, Banda Aceh, Indonesia, from January until May 2017. We include all patients who received twice-weekly hemodialysis for at least 3 months. Patients who received corticosteroids in the past 2 weeks, pregnant, suffering from endocrine disorders or malignancy, autoimmune diseases, and thalassemia, and menopausal women, were excluded. Laboratory examination and Bone Densitometry were performed before a single hemodialysis session. Data were analyzed using the Spearman Rank Correlation test. Results: Thirty patients were analyzed from 196 hemodialysis patients. The proportion of patients that have vitamin D insufficiency was 56.6%. The proportion of patients that have with normal vitamin D was 43.3%. The proportion of patients that have osteoporosis was 30% and 56.6% were osteopenia based on bone densitometry examination. The magnitude of the Spearman Rank Correlation coefficient between vitamin D levels and the duration of hemodialysis in CKD patients is-0.552 with a p-value
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