May Measurement Month 2017: an analysis of blood pressure screening results in China—East Asia

Abstract

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. In China, several hypertension screening programmes are undertaken in the elderly in the community and in youths at university entrance and graduation. However, most people, especially the middle-aged working population, do not often have their BP measured. The current awareness (46.9%), treatment (40.7%), and control rates (15.3%) of hypertension remain low, while the proportion of screenees with hypertension is high in adult Chinese (23.2%). An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2017. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. About 125 236 individuals were screened. After multiple imputation, with 124 623 as denominator, 32 089 (25.7%) had hypertension. Of the 103 981 individuals not on antihypertensive medication, 11 447 (11.0%) were hypertensive. Of the 20 547 individuals on antihypertensive medication, 7392 (36.0%) had uncontrolled BP (≥140/90 mmHg). An opportunistic screening may effectively identify those with high BP regardless of the use of antihypertensive medication and shows similar information on BP as a survey in a randomly selected population sample.

An overview of hypertension and cardiac involvement in Asia: Focus on heart failure

“…Hypertension has also been reported as the leading CV risk factor in Indonesia, explaining 20%‐25% of all coronary artery disease (CAD) and 36%‐42% of all strokes . Interestingly, the awareness, proportion of those with well controlled BP, and hypertension‐mediated organ damage (HMOD) also vary among countries in Asia, as reported in global BP screening campaign initiative of International Society of Hypertension in Asian countries …”

Barriers to blood pressure control in China in a large opportunistic screening

“…As one of the China nationwide initiatives for improving the management of hypertension, we actively participated in the May Measurement Month (MMM) project, 6‐8 organized by the International Society of Hypertension in collaboration with the World Hypertension League and the Lancet Commission on Hypertension 9 . The earlier collected data in 2017 in 125 236 participants were included in the pooled analysis of the worldwide project 6,7 . However, in the whole measurement period in 2017, a total of 364 000 study participants had their blood pressure measured and had sufficient quality of data.…”

What is new in the 2018 Chinese hypertension guideline and the implication for the management of hypertension in Asia?

“…Several technological platforms, such as those mentioned above, are being established. Several nationwide hypertension control programs have been started in the framework of the Healthy China 2030 Initiative, with a goal of 50% control rate of hypertension by 2030 …”