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

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          Abstract

          May Measurement Month (MMM) is a global initiative to screen high blood pressure (BP) in the community and increase awareness at the population level. High BP is the leading risk factor for mortality worldwide and in Nepal. This study presents the results of the 2019 MMM in Nepal. Opportunistic BP screening was conducted in 30 out of 77 districts across Nepal and aged ≥18 years at the community and public places. BP was measured three times in a seated position. A total of 74 205 individuals participated in the study, mean age 39.9 years, and 58% were male. BP measurements for the second and third readings were available for 69 292 (93.3%) individuals. The proportion of the population that were hypertensive was 27.5% ( n = 20 429). Among those hypertensives, 46.3% were aware of their hypertensive status and of these, 37.5% were on antihypertensive medication. Only 54.3% of those on antihypertensive medication had their BP controlled. Of the community screened, those self reporting to have diabetes, current tobacco users, and current alcohol drinkers were 6.7%, 23.6%, and 31.9%, respectively; 20.6% of the participants were overweight, and 6.5% were obese. Since the first BP screening campaign, MMM 2017 in Nepal, the number of participants screened has largely increased over the years. MMM’s success in Nepal is through a coordinated mobilization of trained health science students and volunteers in the communities. The Nepal MMM data demonstrates that large community-based BP screening campaigns are possible in low resource settings.

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          May Measurement Month 2019: The Global Blood Pressure Screening Campaign of the International Society of Hypertension

          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.
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            Awareness, Prevalence, Treatment, and Control of Hypertension in Western Nepal.

            Hypertension is a significant contributor to cardiovascular and renal diseases. In low-income settings like Nepal, there are few epidemiological studies assessing hypertension burden. Thus, the purpose was to determine prevalence, awareness, treatment, and control of hypertension in Nepal.
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              Building Strong Primary Health Care to Tackle the Growing Burden of Non-Communicable Diseases in Nepal

              ABSTRACT Nepal is currently facing a double burden of non-communicable diseases (NCDs) and communicable diseases, with rising trends of NCDs. This situation will add great pressure to already fragile health systems and pose a major challenge to the country’s development unless urgent action is taken. While the primary health care approach offers a common platform to effectively address NCDs through preventive and curative interventions, yet its potential is not fully tapped in Nepal. In line with the Alma Ata and Astana Declarations, we propose an integrated approach for Nepal, and other low-and middle-income countries, including six key reforms to enhance the primary care response to the increasing burdens of NCDs.
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                Author and article information

                Journal
                Eur Heart J Suppl
                Eur Heart J Suppl
                ehjsupp
                European Heart Journal Supplements : Journal of the European Society of Cardiology
                Oxford University Press
                1520-765X
                1554-2815
                May 2021
                20 May 2021
                20 May 2021
                : 23
                : Suppl B , The Heart of the Matter - May Measurement Month 2019 - the global blood pressure screening programme of the International Society of Hypertension: results from 47 countries
                : B110-B113
                Affiliations
                [1 ]Nepal Development Society , Bharatpur-10, Chitwan 44200, Nepal
                [2 ]Research Center in Emergency and Disaster Medicine (CRIMEDIM), Università del Piemonte Orientale (UPO) , Novara (NO) 28100, Italy
                [3 ]Research Group on Emergency and Disaster Medicine (ReGEDiM), Vrije Universiteit Brussel (VUB) , Jette 1090, Belgium
                [4 ]Centre for Healthy Futures, Health Faculty, Torrens University , NSW 2009, Sydney, Australia
                [5 ]Institute of Medicine, Tribhuvan University , Maharajgunj, Kathmandu 44600, Nepal
                [6 ]Center for Global Health, Department of Public Health, Aarhus University , Aarhus 8000, Denmark
                [7 ]Nepal Public Health Association , Talchikhel, Lalitpur 44700, Nepal
                [8 ]Ministry of Health and Population , Ramshahpath, Kathmandu 44600, Nepal
                [9 ]Birat Medical College and Teaching Hospital , Tankisinuwari, Biratnagar 56613, Morang, Nepal
                [10 ]Nepal Medical Volunteer Society , Biratnagar 56613, Morang, Nepal
                [11 ]Department of Medicine, Section of Cardiovascular Medicine, Wake Forest School of Medicine , Winston-Salem, NC, USA
                [12 ]Manmohan Memorial Institute of Health Sciences , Soalteemode, Kathmandu 44600, Nepal
                [13 ]Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University , Kathmandu 44600, Nepal
                [14 ]Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University , Kathmandu 44600, Nepal
                [15 ]Imperial Clinical Trials Unit, Imperial College London, Stadium House , 68 Wood Lane, London W12 7RH, UK
                [16 ]Department of Primary Care and Public Health, Imperial College London , St Dunstan's Road, London W6 8RP, UK
                [17 ]Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University , Baltimore, MD 21287, USA
                Author notes
                Corresponding author. Tel: +14105029170, Email: dneupan2@ 123456jh.edu
                Article
                suab042
                10.1093/eurheartj/suab042
                8141957
                34054371
                5657fb0d-b073-437a-9be4-f89463392b8f
                Published on behalf of the European Society of Cardiology. © The Author(s) 2021.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Page count
                Pages: 4
                Funding
                Funded by: Omron Healthcare, Inc., DOI 10.13039/100016274;
                Funded by: Public Health Institute, DOI 10.13039/100001808;
                Funded by: US Centres for Disease Control and Prevention;
                Funded by: International Society of Hypertension, DOI 10.13039/100011054;
                Funded by: Buddha Cement Private Limited;
                Funded by: Jayanti Memorial Trust;
                Funded by: Mrigendra Samjhana Medical Trust;
                Funded by: NPL Social Welfare Organization;
                Funded by: Nepal Development Society;
                Categories
                Articles
                AcademicSubjects/MED00200

                hypertension,blood pressure,screening,treatment,control,nepal
                hypertension, blood pressure, screening, treatment, control, nepal

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