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

Abstract

High blood pressure (BP) is a major risk factor for cardiovascular diseases and was identified as the most significant single preventable cause of mortality. The prevalence of hypertension in Saudi Arabia is high. To raise awareness and identify undiagnosed hypertension, the Saudi Ministry of Health participated in the May Measurement Month (MMM) 2019 global screening initiative of the International Society of Hypertension. Ninety-two primary care centres across the Kingdom recruited respondents aged ≥18 years through opportunistic sampling, from 1 May to 30 August of 2019. Data collection included sociodemographic, lifestyle habits, environmental, and anthropometric indicators. Blood pressure was measured twice using automated BP devices. A total of 25 023 adults were screened with a mean age of 42.4 (16.7) years and a mean body mass index of 27.5 (6.0) kg/m2. In total, 43.6% of participants were females and 56.4% were males. Of all the participants with hypertension, 60.8% were aware, 60.8% were on antihypertensive medication, and 39.3% had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). Moreover, out of 4440 participants on antihypertensive medication, only 64.6% had controlled BP. The high numbers of individuals with hypertension and with undiagnosed hypertension highlight the importance of BP screening campaigns to increase awareness, detection, and target treatment on a national level. Findings from this study can form a baseline by which to measure progress in future iterations of MMM.

Patient Journey for Hypertension and Dyslipidemia in Saudi Arabia: Highlighting the Evidence Gaps

“…Further, proportion of patients adhering to antihypertensive medications was reported to be low (22.5%) [22] similar to the ndings from other Middle Eastern countries like OPT (16.9%) [43], but was lower than UAE (42.0%) [44]. Likewise, a huge variation was observed in the proportion of patients achieving BP control (27.0%-45.0%) [10,19,23,24,29] while HICs including Canada and Germany reported higher BP control (50.0%-69.0%) [42].…”

“…Although Saudi Arabia displays heightened hypertension awareness when compared with other Middle East countries, the hypertension awareness rates were still lower when compared with other high-income countries (HICs) such as Germany and South Korea (40%-80%) [19,40]. Except for two screening campaigns held nationwide and in Eastern province, respectively, the review ndings suggested a paucity in screening studies across Saudi Arabia (100.0%) [24,26,28]. The reason for high screening rates is simply because all the patients underwent screening as part of the survey protocol which did not include targeted screening.…”

“…The overall prevalence estimates of hypertension were represented in a wide range, which could be attributed to the heterogeneity of patients' baseline characteristics, differences in the study settings (community-based or hospital-based), and difference in the severity of the disease. The prevalence reported from community-based settings were lower (14.0%-36.0%) [10,11,19,20,23,28-,29,30] than the hospital-based settings (14.6%-41.8%) [18, 24,25] which is indicative that a majority of patients visiting the primary healthcare (PHC) were with underlying cardiovascular (CV) risk factors, hypertension being one of them. Other reasons may include differences in the study duration between the two settings and its corresponding effect on disease severity and differences in diagnostic practices across different locations [18].…”

“…Although rates of diagnosis have improved over the last decade (from 11.5%-47.1%), they still remain low when compared to HICs such as South Korea, Canada, and Iceland where almost 70% of the hypertensives were accurately diagnosed [41,42]. A wide variability was observed in the proportion of patients undergoing treatment (27.9%-78.9%) [10,19,21,23,24,29]. Similar to the awareness touchpoint, the treated participants mainly belonged to geriatric, female, comorbid and educated cohorts [10,18,19].…”

“…Twenty-four studies from structured search were excluded as they did not match the MAPS criteria de nition for patient journey touchpoints. Finally, four studies from the structured searches [10,11,18,19] and 10 studies from the unstructured searches [20][21]22,23,24,25,26,27,28,29] were included in the nal analyses. The literature search and study selection process are presented in Fig.…”