The Pan American Health Organization (PAHO)-World Hypertension League (WHL) Hypertension Monitoring and Evaluation Framework is summarized. Standardized indicators are provided for monitoring and evaluating national or subnational hypertension control programs. Five core indicators from the World Health Organization hearts initiative and a single PAHO-WHL core indicator are recommended to be used in all hypertension control programs. In addition, hypertension control programs are encouraged to select from 14 optional qualitative and 33 quantitative indicators to facilitate progress towards enhanced hypertension control. The intention is for hypertension programs to select quantitative indicators based on the current surveillance mechanisms that are available and what is feasible and to use the framework process indicators as a guide to program management. Programs may wish to increase or refine the number of indicators they use over time. With adaption the indicators can also be implemented at a community or clinic level. The standardized indicators are being pilot tested in Cuba, Colombia, Chile, and Barbados.

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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. National Health Surveys, PURE and CESCAS Chilean cohorts have shown a high prevalence of hypertension, with a significant proportion of people unaware of being hypertensive or under treatment but with uncontrolled BP. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the MMM protocol. Sixty-seven sites participated. Most screening sites were National Heath Public System outpatient clinics, mainly in the 9th region of the country. In addition, clinical research sites and private clinics participated. Overall, 4754 individuals were screened during MMM17. After multiple imputations, 1153 (24.2%) had hypertension. Of individuals not receiving anti-hypertensive medication, 653 (15.3%) were hypertensive. Of the 500 individuals receiving anti-hypertensive medication, 162 (32.5%) had uncontrolled BP. MMM17 was one of the largest BP screening campaigns performed in Chile. It demonstrated a high proportion of hypertension among screenees with a low proportion the individuals with controlled hypertension in the community. The high percentage of persons untreated or with uncontrolled hypertension whilst on pharmacologic treatment suggests that systematic screening programmes may be a useful tool to improve hypertension control in Chile.

ObjectivesThis study estimates the prevalence of chronic kidney disease (CKD) among Chilean adults and examines its associations with sociodemographic characteristics, health behaviours and comorbidities.DesignAnalysis of cross-sectional data from the two most recent large nationally representative Chilean Health Surveys (Encuesta Nacional de Salud, ENS) 2009–2010 and 2016–2017.ParticipantsAdults aged 18+ years with serum creatine data (ENS 2009–2010: n=4583; ENS 2016–2017: n=5084).Primary and secondary outcome measuresReduced kidney function (CKD stages 3a–5) based on the estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2) was the primary outcome measure. Using the urine albumin-to-creatinine ratio (ACR ≥30 mg/g), increased albuminuria was ascertained among adults aged 40+ years with diabetes and/or hypertension. Both outcomes were analysed using logistic regression with results summarised using OR. CKD prevalence (stages 1–5) among adults aged 40+ years was estimated including participants with an eGFR of >60 mL/min/1.73 m2 but with increased albuminuria (stages 1–2).ResultsOverall, 3.2% (95% CI: 2.4% to 3.8%) of adults aged 18+ in ENS 2016–2017 had reduced kidney function. After full adjustment, participants with hypertension (OR: 2.37; 95% CI: 1.19 to 4.74) and those with diabetes (OR: 1.66; 95% CI: 1.03 to 2.66) had significantly higher odds of reduced kidney function. In ENS 2016–2017, 15.5% (13.5% to 17.8%) of adults aged 40+ years with diabetes and/or hypertension had increased albuminuria. Being obese versus normal-weight (OR: 1.66; 95% CI: 1.08 to 2.54) and having both diabetes and hypertension versus having diabetes alone (OR: 2.30; 95% CI: 1.34 to 3.95) were significantly associated with higher odds of increased albuminuria in fully-adjusted analyses. At least 15.4% of adults aged 40+ years in ENS 2016–2017 had CKD (stages 1–5), including the 9.6% of adults at CKD stages 1–2.ConclusionsPrevention strategies and Chilean guidelines should consider the high percentage of adults aged 40 years and older at CKD stages 1–2.

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