Blood pressure screening during the May Measurement Month 2017 programme in Vietnam—South-East Asia and Australasia

Associated Data

Supplementary Materials
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Abstract

Elevated rake blackmail ( BP ) is a growing charge cosmopolitan, leading to over 10 million deaths each year. May Measurement Month ( MMM ) is a ball-shaped enterprise aimed at raising awareness of high BP and to act as a temp solution to the miss of screening programmes cosmopolitan. Our aim was to screen for high blood pressure ( HTN ) and cardiovascular risk factors in people aged ≥18 years in the community, thereby define the proportion of subjects with elevated railway BP and assess the awareness and the effectiveness of its treatment. An opportunist cross-sectional survey of volunteers aged ≥18 years was carried out in May 2017. Blood pressure measurement, the definition of HTN and statistical psychoanalysis followed the standard MMM protocol. From May 2017 to June 2017, through 10 cities/provinces in Vietnam, 10 993 individuals with mean age 49.1 ± 16.2 years were screened during MMM17. After multiple imputation, 3154 ( 28.7 % ) had HTN. Of individuals not receiving antihypertensive medicine, 1509 ( 16.1 % ) were hypertensive. Of individuals receiving antihypertensive medication, 620 ( 37.7 % ) had uncontrolled BP. Raised BP was besides associated with extra hazard factors including smoke, alcohol, overweight-obesity, and diabetes. May Measurement Month 17 was the largest BP screening campaign ever undertaken in Vietnam. Undiagnosed and uncontrolled HTN in Vietnam remains a solid health trouble. local anesthetic campaigns applying standardize methods such as MMM17, will be highly useful to screen for the significant number of individuals with raised BP and increase the awareness of HTN .

Introduction

arterial high blood pressure ( HTN ) remains a ball-shaped charge not merely for build up countries but besides for developing countries. 1 Vietnam in the Asia Pacific region is located in the major regions with high HTN prevalence. 2 In the concluding years, the National HTN Program in Vietnam has been conducted in many provinces of Vietnam. 3–5 The prevalence of HTN in Vietnam was estimated to be 25.1 %, including those who were unaware of their HTN. Annually HTN causes 91 600 deaths ( 20.8 % of total deaths ) and 7.2 % of Disability adjusted life years lost, chiefly through increased stroke and cardiovascular disease. 6 The May Measurement Month ( MMM ) course of study 2017 was a alone ball-shaped first step organized by the International Society of Hypertension ( ISH ) to increase the awareness about the risks associated with HTN by measuring the blood pressure ( BP ) of the general population. 7 Since then, the MMM program was sky-high responded to by Vietnam National Heart Association/Vietnam Society of Hypertension ( VNHA/VSH ) by launching and deploying it across the whole nation. The goal of the MMM 2017 broadcast was to screen at least 10 000 people over the senesce of 18 years across the area to inform participants of the risks associated with HTN ampere good as to inform governmental organizations in order to further strengthen the existing HTN prevention program .

Methods

We selected 10 cities and provinces of the three regions of Vietnam : the North ( Hanoi, Vinh, Thanh Hoa ), the Central and Highlands ( Hue, DaNang, QuiNhon, TuyHoa, Daklak ), and the South ( Ho Chi Minh City, Cantho ). The co-ordinators are members of the VNHA/VSH executive committee and/or the directors of the local health departments. Volunteers were members of the Red Cross, the VNHA/VSH, among others, american samoa well as medical students. There was an average of 50 persons per locate. The sites of the screen were identical deviate, and included medical facilities, theatres, supermarkets, factories, schools, train stations, bus topology stations. Adults ≥18 years who had not had their BP tested for the former year were selected. Screening time was from May 2017 to June 2017. Patients voluntarily participated. The screening protocol was approved by the VNHA/VSH and the Ministry of Health in terms of ethics. Blood pressure machines were semi-automatic OMRON HEM-7121. The BP method acting was based on the ISH protocol for MMM 7 noting particularly that the clock between BP measurements is 1 min with three measurements taken, allowing the average BP of the last two measurements to be calculated. Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg or on antihypertensive treatment. The body batch index ( BMI ) was classified according to asian standards. 5 The view questionnaire of the ISH for the MMM program was used. Data collected by Excel 2013 ; processed and analysed using Stata translation 14.2 by the MMM team .

Results

About 10 993 individuals were screened during MMM17. The majority of those screened were women ( 61.6 % ), and the hateful age of both sexes was 49.1 ± 16.2 years. Of these, 15.0 % of patients were on medicine for HTN. Of other recorded information, 5.5 % of participants had diabetes, 13.8 % smoked, 13.8 % had alcohol and an average BMI of 22.1 ± 3. table shows the characteristics of the participants.

Table 1

Gender Female Male Unknown
6770 (61.6%) 4217 (38.4%) 6 (0.1%)
Age (years) Mean ± SD 49.1 ± 16.2
Ethnicity Kinh Other
8.225 (91.1%) 1088 (9.9%)
On antihypertensives No Yes Unknown
medication 9338 (84.9%) 1645 (15.0%) 10 (0.1%)
Diabetes No Yes Unknown
9736 (88.6%) 599 (5.5%) 658 (6.0%)
Current smoker No Yes Unknown
9468 (86.1%) 1514 (13.8%) 11 (0.1%)
Alcohol intake Rarely ≥ Once per week Unknown
10 245 (93.2%) 735 (6.7%) 13 (0.1%)
BMI (kg/m2) Mean ± SD 22.1 ± 3.0
Total participants 10 993 100.0%

Open in a separate window After imputation, and standardizing for age and sex, mean BP values were 120.2/75.6 mmHg, and in those on antihypertensive treatment was 130.2/81.1 mmHg ( Table ) .

Table 2

Crude BP Age- and sex-standardized BP Age- and sex-standardized BP excluding those on treatment Age- and sex-standardized BP in those on treatment
SBP (mmHg) 121.2 120.2 119.4 130.2
DBP (mmHg) 75.8 75.6 75.1 81.1
Denominator 8982 10 969 9327 1642

Open in a separate window After imputation, of 10 989 individuals with a mean BP available, the share of participants with HTN was 28.7 % ( normality = 3154 ). Of 9344 individuals not on discussion, 1509 ( 16.1 % ) had HTN. Of 1643 individuals on antihypertensive discussion and with an available BP read, 37.7 % had an uncontrolled BP. supplementary material on-line, Figure S1 shows the association of BP with early individual factors. Patients on antihypertensive medicine, current smokers, and regular alcohol drinkers had importantly higher systolic BP ( SBP ) and diastolic BP ( DBP ). Patients with diabetes had significantly higher SBP, but not DBP. Supplementary material on-line, Figure S2 shows the association with BMI. significant analogue increases were seen in SBP and DBP in moving from scraggy to corpulent BMI categories .

Discussion

The percentage of screen subjects with lift BP was higher compared to previous surveys in Vietnam including those reported by Son et aluminum. ( 25.1 % ) 3 and Ha et alabama. ( 23 % ), 8 but slightly lower than in the reputation by Hoang et alabama. ( 33.8 % ) 9 and Nguyen et alabama. ( 32 % ). 6 For other asian countries, in our region the proportion of HTN was estimated to be between 15 and 35 %. In general, lower-income countries in the area have lower rates 2, 10 which may explain some of the differences within the region and over prison term. In Vietnam, the increase rate of fleshiness and diabetes mellitus in recent years are besides likely to track with raise HTN rates. 1, 6 It appears as if the efforts made through National Programmes and the health sector in Vietnam, may have resulted in better management of HTN as indicated by a smaller proportion of subjects ( 16.1 % ) not being treated for their HTN compared to previous studies. 3, 5, 8 Studies in former years in Vietnam indicate that about only one-third of cases of HTN were controlled, but the results of MMM show that 62.3 % of those on treatment were controlled. 9 While awareness may have increased, there may be other factors which explain this. In 1993, among 25–64 vietnamese years erstwhile, overweight-obesity to be 2.3 %, in 2015 the incidence of overweight-obesity was up to 15 %, and diabetes mellitus was reported to be 4.1 % and dyslipidaemia 32 %. 6 Another study conducted in Ho Chi Minh City showed that the fleshiness rate reached 23 %, diabetes 5.9 %, and lipid disorders 56.2 %. 9 This matched our MMM 2017 screening results with regards to the associations of BP with corpulent or non-obese patients. Do et al. 5 showed, across her study in 2005, that BMI was a cardiovascular risk factor freelancer of HTN. The prevalence of overweight-obesity was 22.49 % higher in the HTN group, compared to the control group. Compared to our national study in 2012, 3 the rate of overweight-obesity was importantly higher in the present study. Obesity is not entirely causally linked to HTN but besides to diabetes. The number of subjects with diabetes mellitus ; however, was relatively minor, possibly due to lack of allow tests and tools for examining the patients ’ lineage glucose in our sketch. In line with former investigations weight amplification, inactivity, alcohol consumption, fume, salt inhalation, and diabetes mellitus emerged as determinants of HTN. 10

In conclusion, the MMM 2017 course of study was a bombastic awareness campaign across the ball including the health system in Vietnam. From our findings, we conclude that there is an ongoing need for cardiovascular health screen and rede in the community to improve detection and management of promote BP as a bad non-communicable disease .

Acknowledgements

The authors sincerely thank the Ministry of Health, VNHA, OMRON Company, SERVIER Company, the University of Medicine & Pharmacy, Health Services, Hospitals, Doctors, Volunteers in 10 cover sites, and Hue Cardiovascular Student Club ; peculiarly they would like to thank the ISH leaders, MMM leaders, ISH secretary, and ISH statistic team. Conflict of interest: none declared .

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