RESUMO
Hypertension, the foremost cause of global morbi-mortality, is linked with a high mortality from numerous cardiovascular endpoints. The May Measurement Month (MMM) campaign is an annual initiative of the International Society of Hypertension (ISH) to collect information on blood pressure (BP) and other risk factors for cardiovascular disease (CVD) in adults. MMM2019 in the Democratic Republic of the Congo (DRC) was an opportunistic cross-sectional survey of volunteers aged ≥18 years that took place in Kinshasa and Mbuji-Mayi after the training of observers to familiarize with the ISH ad hoc methods. We screened 29 857 individuals (mean age: 40 years; 40% female). Hypertension was present in 7624 (25.5%) individuals. Of them, 2520 (33.1%) were aware, 1768 (23.2%) on treatment with 910 (51.5%) controlled BP (systolic BP <140 mmHg and/or diastolic BP <90 mmHg). Of all hypertensives screened, 11.9% had controlled BP. Of all respondents, 16.7% had participated in MMM18 and 60.5% did not have their BP verified during the last year. Fasting, pregnancy, and underweight status were linked with lower BP levels whilst smoking, drinking, antihypertensive medication, previous stroke, diabetes as well as being overweight/obese were associated with higher BP levels. Our results reflect the high rate of hypertension in the DRC with low levels of awareness, treatment, and control. A nationally representative sample is required to establish the nationwide hypertension prevalence.
RESUMO
Hypertension (HT) is the largest contributor to cardiovascular disease mortality and is characterized by high prevalence and low awareness, treatment, and control rates in sub-Saharan Africa. May Measurement Month (MMM) is an international campaign intended to increase awareness of high blood pressure (BP) among the population and advocate for its importance to the health authorities. This study aimed to increase awareness of raised BP in a country where its nationwide prevalence is yet unestablished. Investigators trained and tested how to use the campaign materials, collected participants' demographic data, lifestyle habits, and obtained from each one three BP measurements. Hypertension was defined as a BP ≥140/90 mmHg, or use of antihypertensive medication. Of the 18 719 screened (mean age 41 years; 61.4% men), 26.1% were found to be hypertensive of whom 46.3% were aware of their condition and 29.6% were taking antihypertensive medication. The control rate of HT was 43.0% in those on medication and 12.7% among all hypertensive respondents. Comorbidities found were-diabetes (3.3%), overweight/obesity (35.5%); and a previous stroke and a previous myocardial infarction were reported by 1.2% and 2.0%, respectively. Imputed age- and sex-standardized BP was higher in treated hypertensive individuals (135/85 mmHg) than those not treated (124/78 mmHg). Based on linear regression models adjusted for age and sex (and an interaction) and antihypertensive medication, stroke survivors, those who drank once or more per week (vs. never/rarely), and overweight/obese participants were associated with higher BP. MMM18 results in the Democratic Republic of the Congo corroborated the high prevalence of HT in Kinshasa screenees with low rates of treatment and control. Extension of the MMM campaign to other parts of the country is advisable.
