May Measurement Month 2019: an analysis of blood pressure screening results from Bangladesh

Abstract

According to the Non-communicable disease Risk Factors Survey of 2018, more than one-fifth (21.0%) of adults aged 25 years or older have hypertension and one-third of the adults did not have their blood pressure (BP) measured in their lifetime in Bangladesh. The National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2017 and 2018 as well as this 2019 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. This opportunistic screening of voluntary participants aged ≥18 years was carried out from May to July 2019. Data were collected from 100 screening sites in 16 districts in Bangladesh. BP measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Data on 24 941 individuals were analysed. Among the participants, 12 658 (50.8%) were female. After multiple imputation, 6990 (28.0%) had hypertension. Among the 6990 participants with hypertension, 5007 (71.6%) were on antihypertensive medication and 5331 (76.3%) were aware of having hypertension. Among 6990 participants with hypertension, 3217 (46.0%) had controlled BP (<140/90 mmHg) and among the participants with hypertension and on antihypertensive medication, 64.2% had controlled BP. Opportunistic BP screening can identify significant numbers of people with raised BP and thus assist in the prevention of cardiovascular diseases.

Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis

“…The overall mean awareness among hypertensive subjects was 48% (95% CI: 0.45–0.51). In seven studies it was less than 20% (Burkina-Faso [ 36 ], Cameroon [ 41 ], Ghana [ 49 ], India [ 73 ], Malawi [ 86 , 87 ] and Samoa [ 104 ]), while in four surveys is was higher than 75% (Bangladesh [ 32 ], India [ 69 ], Iran [ 80 ] and Pakistan [ 101 ]). Awareness was lower in LICs (0.31; 95% CI: 0.23–0.39) compared to MICs (0.50; 95% CI: 0.48–0.53) Figure 2 .…”

“…Overall, 35% of hypertensive subjects were in treatment (95% IC: 0.32–0.38). Estimates ranged from 3% in Angola [ 27 ] to over 70% in Bangladesh [ 32 ], Iran [ 80 ]and Pakistan [ 101 ], although about half of the studies found a percentage of treated subjects between 20% and 50%. Treatment of hypertension was higher in LMICs (0.36; 95% CI: 0.33–0.39) than in LICs (0.22; 95% CI: 0.17–0.27) ( Figure 3 ).…”

“…Overall, 16% of hypertensive subjects had their hypertension controlled (95% CI: 0.14–0.18). Three studies reported a control of hypertension <2% (Angola [ 27 ], Cameroon [ 41 ] and Ghana [ 49 ]), whereas two studies in Bangladesh [ 31 , 32 ], one in India [ 68 ] and two in Iran [ 78 , 80 ] found >40% of controlled hypertensive subjects. In LICs the percentage of controlled hypertension was lower than LMICs (11% vs .…”

Blood Pressure Screening at a Non-Government Tertiary Care Hospital in Bangladesh: A Pilot Study

“…In that study, only 46% of all pre-existing hypertensives had their blood pressure controlled; this finding indicated a treatment gap or compliance gap or both. 3 As per the guideline from the world hypertension league, majority of people in low resource country are unaware of hypertension and do not have adequate access to health care system. [7][8] Recommendation for community based blood pressure screening also came from systematic review of literatures.…”

“…2 As per the data from non-communicable disease risk factor survey of Bangladesh, more than one one-third of the adults did not have their blood pressure measured in lifetime. 3,4 According to WHO NCD STEPS (World Health Organization STEPwise approach to surveillance for Non-communicable Disease) survey in 2018, 21% of adults aged 25years or above had hypertension whereas half of them were unaware of having high blood pressure. 5 The current paper presents the results of a blood pressure screening program conducted at a non-Government medical college of Bangladesh, on observation of world hypertension day.…”