During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure (BP) across different communities in Botswana. Study sites included four large villages and Gaborone (capital city). Screening sites were shopping malls, train stations, churches, and workplaces. Individuals aged ≥18 years were recruited through fliers, word of mouth, and as volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three BP readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used and was estimated using multiple imputation where missing. Amongst 4599 participants whose BPs were measured, 54.5% were female, while mean age was 35.9 years. A total of 1510 (32.8%) participants were hypertensive and of those, 712 (47.1%) were aware of the hypertension. Only 35.2% of hypertensives were on antihypertensive treatment with 54.4% had controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Risk factors associated with higher BP included obesity, more than 1 unit of alcohol/week and BP measured on Sunday. Less than half (47.1%) of those identified as having hypertension during MMM18 were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
The May Measurement Month (MMM) 2019 campaign aimed to raise awareness of the health issues surrounding raised blood pressure (BP) among the general public. It also sought to identify and facilitate reduction of BPs of participants who require intervention to lower their BP according to current country treatment guidelines. Participants aged ≥18 years were recruited on site through interactions with the study team, educational fliers, and as voluntary walk-ins in response to the media engagement prior to the campaign. Blood pressures were measured using validated upper-arm cuff electronic devices provided by Omron Healthcare in partnership with International Society of Hypertension. With the participant seated, their back supported and legs resting uncrossed on the ground, three BP and heart rate readings were taken and recorded, 1 min apart. Participants’ basic demographic data were also collected. Hypertension was defined as being on treatment for hypertension, or a systolic BP ≥140 mmHg and/or a diastolic BP ≥90 mmHg (based on the mean of the last two of three readings). Of the 5459 screened participants, 1750 (32.1%) had hypertension, of whom 784 (44.8%) were aware they were hypertensive and 726 (41.5%) were on antihypertensive medication. Among those on antihypertensive treatment, 47.0% had their BP controlled (<140/90 mmHg). Only 19.5% of all those with hypertension had their BP controlled. A total of 1024 (21.6%) of the 4733 participants not on antihypertensive treatment were hypertensive. Intensified preventive and treatment measures to control BP at the health system, individual and population levels remain a critical requirement for Botswana.
Objective: During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure across different communities in Botswana. Design and method: Study sites were four large villages and Gaborone (capital city). Screening sites included shopping malls, train stations, churches and workplaces. Individuals aged over 18 years were recruited through fliers, word of mouth and volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three blood pressure (BP) readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: SBP above 140 mmHg or DBP above 90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used, and was estimated using multiple imputation where missing. Ethical clearance was obtained from the Ministry of Health and University of Botswana. Results: Amongst 4,599 participants whose BPs were measured, 54.5% were female, mean age was 35.9 years. A total of 1,510 (32.8%) participants were hypertensive with 712 (47.1%) aware of the hypertension. In participants not taking antihypertensive medication, the association between age and sex with SBP showed a linear increase, with the mean BP in males prominently higher than the mean BP in females across ages below 85–90 years, where they became equal. The DBP association showed an inverted U curve, with the mean DBP in males exceeding the mean DBP in females at age of 25 years, and the peak on the male curve at ages 45–50 years, while in females it was at ages 50–55 years. Only 35.2% of hypertensives were on anti-hypertensive treatment with 54.4% having controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Factors associated with higher BP included obesity, more than 1unit of alcohol/week and BP measured on Sunday. Conclusions: Less than half (52.9%) of those identified to have hypertension during MMM18 campaign were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like the MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
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