tim mạch

1. Professor Neil R Poulter
Director Imperial Clinical Trials Unit
Imperial College London UK
President of The International Society of Hypertension (ISH)
3rd Vietnamese Congress of Hypertension
Nha Trang City: Vietnam
11th-13th May 2018
Global Trends in Hypertension and the
Impact of MMM

2. Health Statistics and Informatics
Deaths attributed to 19 leading factors,
by country income level, 2004

3. Global Burden of Disease Due to Risk Factors by
disease type: 2010
CV &
Circulatory
Lancet 2012

4. Lancet 2005;365:217-23
Hypertension: Size of the Problem - Global
Prospects

5. 22.6
37.2 39.1
20.9
34.8
23.7
19.7
14.5
28.3
17.0
40.7
20.6
26.9
22.0
35.3
37.4
0
10
20
30
40
50 Men
Women
Prevalence of hypertension in people aged 20 years and older
Prevalence of hypertension is high
Kearney PM et al.,Lancet. 2005;365:217-223
44.5
27.7
18.8
42.5
45.9
23.6
40.2
17.1
28.227.0
24.022.9
39.1
41.6
27.027.0
0
10
20
30
40
50
Prevalenceofhypertension(%)
2000
2025

7. “Raised blood pressure continues to be
the biggest contributor to the global
burden of disease and to global mortality,
leading to 9.4 million deaths each year.”
Poulter et al. Lancet 2015

8. Development and Risk Factors
RISES FALLS
Age
Exercise
Alcohol intake
Salt intake
Potassium intake
Body weight
Stress
Smoking
Sat fats
?
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







9. Income level n Aware (%) Treated (%) Controlled
(%)
High 6263 49.0 46.7 19.0
Upper Middle 18123 52.5 48.3 15.6
Lower Middle 23269 43.6 36.9 9.9
Low 10185 40.8 31.7 12.7
Total 57840 46.5 40.6 13.2
Hypertension: Awareness, Treatment & Control†
by National Income: 2003 – 2009. PURE Study
† <140/90
Chow et al. JAMA 2013

10. Awareness Treatment and Control of
Hypertension. Health Survey for England (HSE)
1994 - 2011
Year Awareness
%
Treated
%
Controlled
%
1994 46 32 11
1998 53 39 15
2003 62 48 22
2006 66 54 28
2011 71 59 37
SBP≥ 140mmHg or DBP ≥ 90mmHg or on treatment for hypertension

11. Income level n Aware (%) Treated (%) Controlled
(%)
High 6263 49.0 46.7 19.0
Upper Middle 18123 52.5 48.3 15.6
Lower Middle 23269 43.6 36.9 9.9
Low 10185 40.8 31.7 12.7
Total 57840 46.5 40.6 13.2
Hypertension: Awareness, Treatment & Control†
by National Income: 2003 – 2009. PURE Study
† <140/90
Chow et al. JAMA 2013
ONLY 46.5% AWARENESS

12. IN 2017
World Hypertension Day
expanded to become
May Measurement
Month

13. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
MMM17
AIMS:
To highlight the importance of measuring blood pressure
To identify and reduce the BPs of participants from over 100 countries
who require intervention according to
OBJECTIVES:
To recruit participants, aged >18 years, who ideally have not had their
BPs measured in the previous 12 months
To supply diet and lifestyle treatment advice to all those screened who
have BPs in the Hypertensive range
To use the data on untreated hypertension to motivate governments to
improve screening facilities and policies.

14. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
WORLDWIDE COVERAGE
80 countries in total

15. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
TOTAL NUMBERS BY REGION
Region Total Percentage
South-East Asia & Australasia 360,320 29.9%
South Asia 263,239 21.9%
East Asia 180,186 15.0%
Sub-Saharan Africa 130,508 10.8%
Europe 109,044 9.1%
Americas 107,714 8.9%
Northern Africa and Middle East 53,306 4.4%
Total 1,204,317

16. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
WORLD BANK INCOME GROUPS
Income level Total Percentage
Low 18,953 1.6%
Lower middle 828,728 68.8%
Upper middle 240,853 20.0%
High 115,783 9.6%
Total 1,204,317

17. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
COUNTRY NUMBERS (OVER 10,000)
Country Total Percentage
Philippines 271,883 22.6%
India 240,515 20.0%
China 125,239 10.4%
Indonesia 69,507 5.8%
Taiwan 52,606 4.4%
Ukraine 45,507 3.8%
Sudan 44,471 3.7%
Argentina 32,353 2.7%
Ivory Coast 24,563 2.0%
Colombia 22,277 1.9%
Venezuela 21,645 1.8%
Nigeria 19,931 1.7%
Angola 17,496 1.5%
Cameroon 16,093 1.3%
Kenya 14,863 1.2%
Bangladesh 11,418 1.0%
Viet Nam 10,996 0.9%
Italy 10,076 0.8%

18. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
PARTICIPANT CHARACTERISTICS
Variable Total Percentage
On anti-hypertensive medication 240,249 20.0%
Diabetes 103,363 8.6%
Previous MI 37,859 3.2%
Previous stroke 22,006 1.8%
Pregnant 7,118 1.1%
Current smoker 138,928 11.5%
Alcohol intake 90,465 7.5%

19. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
AGE AND SEX BY REGION
Region Mean age (years) Females Males On treatment
Europe 52.2 64,710 (59.6%) 43,942 (40.4%) 42,491 (39.0%)
Northern Africa and Middle East 37.4 19,738 (37.4%) 33,009 (62.6%) 1,742 (3.3%)
Sub-Saharan Africa 39.1 68,739 (54.1%) 58,399 (45.9%) 12,115 (9.3%)
Americas 48.8 64,136 (60.3%) 42,305 (39.8%) 32,319 (30.0%)
South Asia 40.3 118,776 (45.5%) 142,097 (54.5%) 3,612 (5.0%)
South-East Asia & Australasia 42.8 218,350 (61.1%) 138,907 (38.9%) 79,154 (22.0%)
East Asia 54.8 93,956 (53.3%) 82,329 (46.7%) 44,875 (24.9%)

20. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
DIFFERENCE BETWEEN READINGS -
GLOBAL
Reading 1 Reading 2 Reading 3
Mean of 2 & 3
(round up)
Mean of 2 & 3
(round down)
SBP 126.4 124.5 123.3 124.1 123.7
DBP 79.5 78.5 77.9 78.4 78.1
Number of BP
Measurements
Total number*
1st 1,008,068
2nd 800,432
3rd 720,419
2nd and 3rd 701,299
* Not including data from Public Health
Foundation India

21. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
HYPERTENSION
Defined as a BP of 140/90 or more or on treatment for BP
Proportion with hypertension Ω 30%
Number screened with Hypertension and not on treatment >150,000
Number on treatment and not controlled >100,000
Biggest national screen in 34 of 46 countries screened

23. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
SCREENINGS TOOK PLACE AT
Churches
Market Places
Community spaces
Universities
Pharmacies
Supermarkets
Factories
… and people’s doorsteps

24. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
PROMOTED IN MANY WAYS INCLUDING
Celebrity endorsement and TV
coverage (local celebrities who
have suffered from hypertension
– singers, actors, sports
celebrities)
Advertising in scientific journals
Awareness marches
Street Plays
Engagement of rural
community leaders
Endorsement from government
health officials
Cardiff Football Club
Size 8 Gospel Singer
Kenya
Awareness Marches Pakistan

25. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
MMM17: PUBLICATION PLAN
Global Publication(s)
Regional Publications (x 8?)
National Publications (x 20?)
Ethnic Publications
Other ?

26. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
MMM18 AIMS & OBJECTIVES
1. Increase awareness of the health issues around hypertension
– in the public and healthcare arenas
2. Create scientific evidence to inform and influence health policy – to
increase access to BP screening
3. Screen a further 1.5million+ people, who ideally haven’t
had their BP measured for over 1 year and collect quality data

27. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
CAMPAIGN MESSAGES
MMM Strapline: A SIMPLE MEASURE TO SAVE LIVES
MMM call to action: #checkyourpressure
MMM 3 core messages:

28. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
GLOBAL MEDIA CAMPAIGN
Dad, do I have
to talk til
I’m blue in
the face?
Get your
blood
pressure
checked.
Now.”
“
Remember how your parents
told you what to do?
Now it’s your turn.
Make sure your parents and loved ones get their blood pressure checked today
becauseisayso.net May Measurement Month
In 2018, MMM will be boosted by
a Servier global media campaign
This will increase public
awareness and drive interest for
MMM
MMM countries also have the
opportunity to approach local
Servier offices for support in their
screenings
Timing: Build interest in April.
Campaign launches 1st May

29. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
NEW APP FOR 2018
Data collection and submission will be more simple and
faster!
For desktop/laptop, android/ IOS mobile phone or tablet
Offline data collection available
Default settings will reduce duplication of data entry
Scan and capture functionality to allow fast upload of hand
written forms
Available in several languages including English and Hindi
Guidelines and templates available early April

30. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
& help us to save more
lives
MMM18
BE PART OF IT!
Please contact
manager@maymeasure.com

31. A SIMPLE MEASURE TO SAVE LIVES #checkyourpressure
MMM18 – 1 WEEK IN