Community pharmacy-based hypertension screening: May Measurement Month 2023 in 3 Canadian provinces

Lee T.A., King M., Young S.W., Tsuyuki R.T.

AbstractBackground High blood pressure (BP) is a leading cause of cardiovascular and stroke related events. Office-based BP measurement has declined in recent years due to the COVID-19 pandemic, which may have resulted in higher rates of undetected and uncontrolled hypertension. To gain a better idea of adult BP levels in Newfoundland and Labrador (NL), we engaged community pharmacists in BP screening for World Hypertension Day. Methods Data collection and BP screening occurred on May 17, 2022. Pharmacists and pharmacy students collected three seated BP readings from participants using an automated device. The average of readings 2 and 3 was used to estimate BP, where elevated BP was defined as BP ≥ 140/90 mmHg or ≥ 130/80 mmHg for individuals with diabetes. Participant demographics, access to primary care, medical history, and antihypertensive use were also collected. Data analysis included descriptive statistics and logistic regression techniques. Results Four-hundred and sixty participants were included in the analysis. The mean age was 56.3 years (SD 16.95), 63.3% (n = 291) were female, and 43.7% (n = 201) reported having hypertension. Twenty-seven percent (n = 123) had elevated BP. Of those with elevated BP, 41.5% (n = 51) had no history of hypertension. Age, sex, and diabetes were statistically significant predictors of elevated BP in the multivariable model. Conclusions A large proportion of participants in our study had elevated BP. Targeted measures are needed to improve the detection, treatment, and control of high BP in NL. Community pharmacists can support BP care.

Duong D., Vogel L.

Beaney T., Schutte A.E., Stergiou G.S., Borghi C., Burger D., Charchar F., Cro S., Diaz A., Damasceno A., Espeche W., Jose A.P., Khan N., Kokubo Y., Maheshwari A., Marin M.J., et. al.

Elevated blood pressure remains the single biggest risk factor contributing to the global burden of disease and mortality. May Measurement Month is an annual global screening campaign aiming to improve awareness of blood pressure at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at sites in 92 countries during May 2019. Ideally, 3 blood pressure readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg (mean of the second and third readings) or taking antihypertensive medication. When necessary, multiple imputation was used to estimate participants’ mean blood pressure. Mixed-effects models were used to evaluate associations between blood pressure and participant characteristics. Of 1 508 130 screenees 482 273 (32.0%) had never had a blood pressure measurement before and 513 337 (34.0%) had hypertension, of whom 58.7% were aware, and 54.7% were on antihypertensive medication. Of those on medication, 57.8% were controlled to <140/90 mm Hg, and 28.9% to <130/80 mm Hg. Of all those with hypertension, 31.7% were controlled to <140/90 mm Hg, and 350 825 (23.3%) participants had untreated or inadequately treated hypertension. Of those taking antihypertensive medication, half were taking only a single drug, and 25% reported using aspirin inappropriately. This survey is the largest ever synchronized and standardized contemporary compilation of global blood pressure data. This campaign is needed as a temporary substitute for systematic blood pressure screening in many countries worldwide.