Under pressure: how raising awareness of a silent killer can save lives on a global scale

blood pressure screening

Professor Neil Poulter puts blood pressure screening in the spotlight – an effective way of reducing the burden of high blood pressure in the UK and globally.

Blood pressure screening can save lives, which may come as a surprise considering it is such a simple measurement. Blood Pressure UK was set up as a charity aimed at lowering the nation’s blood pressure (UK), with the purpose of preventing or at least reducing disability and death associated with raised blood pressure (BP).  Among their activities, they have been running a ‘Know Your Numbers’ week every year since 2007, and their thirteenth consecutive campaign week is currently underway. ‘Pressure stations’ have been set up around the UK providing free BP screening, encouraging adults across the country to know their blood pressure numbers.

Silent killer

Raised BP (also known as hypertension) is often referred to as the silent killer, and also leads to many other serious conditions such as heart attacks, strokes, kidney disease and dementia.  Despite its seriousness, it is usually symptomless, so many people are unaware they have it.  It costs very little and takes only a few minutes to measure someone’s BP, which if raised, can often be managed through known lifestyle changes or existing medication. But unless the public is screened to make them aware of their BP, then the impact of effective treatments for controlling hypertension is limited.

The prevalence of hypertension in the UK, based on a representative sample of the adult population, was found in 2016 to be 36% (female) and 40% (male).  Awareness rates were higher in women than men (70% and 67% respectively) and treatment rates were also higher among women (59% and 55% respectively).  Control rates, where the condition was managed effectively, were 37% for men and women.   So, in essence, most people who were aware of their condition got treated, but of those who were treated, only around two thirds were controlled.

According to Public Health England, 5.5 million people have undiagnosed high BP, so with BP management clearly posing a threat to the nation’s health, Know your Numbers aims to encourage everyone to know their BP numbers in the same way they would know their height or weight, so that they can take steps now or in the future to stay healthy.

Global reach

This national Know your Numbers campaign is required even more critically in many other parts of the world. According to the most recent Global Burden of Disease study, raised BP is the biggest contributor to disease and mortality worldwide, with 10.4 million raised BP related deaths in 2017.  This burden and lack of priority given to BP monitoring and control in most countries of the world is what led to the launch of ‘May Measurement Month’ by the International Society of Hypertension in 2017. Our aim is that through May Measurement Month we can not only to increase public awareness, but also collect the scientific evidence needed to help influence global health policy and make BP screening more widely available around the world.

Now in its third year, May Measurement Month is the largest global synchronised screening campaign of any cardiovascular risk factor. Relying on the goodwill of thousands of volunteers around the world, sites are set up in cities, towns, and villages throughout the complete month of May, offering BP measuring to the general public. Anyone who has been screened leaves knowing their BP and anyone found to be hypertensive is given advice about what they need to do next.  Furthermore, anonymised data are analysed to create scientific evidence, which we hope can help influence policy makers to improve the availability and quality of BP screening as a simple way to save lives and improve world health.

The global breadth of May Measurement Month covers vastly differing cultures – including the Philippines, China, India, South America, Africa and parts of Europe including the United Kingdom – with the screenings themselves held in many locations, in both remote rural and busier urban areas including, universities, workplaces, markets, shopping malls, places of worship, and this year even saw BP measurements taken at a wedding banquet in Nepal!

Next steps

So far May Measurement Month has exceeded its targets. Screening has taken place in over 100 countries reaching over 1.2 million people in its inaugural year, and a further 1.5 million people in 2018. Of these 2.7 million people, over 580,000 were found to have hypertension and these people can now take action to improve their health.  The data for this year’s campaign are being collated and analysed, but early indications show that around 1.5 million people have had their BP measured.

We feel strongly that raising awareness of the importance of high blood pressure saves lives.  This was recently reinforced by a study in China which showed that identifying high blood pressure, giving non-drug advice and suggesting suitable follow-up be sought, was associated with large and significant reductions in blood pressure.

This is exactly how the MMM and Know Your Numbers campaigns work. So, if you haven’t had your blood pressure checked recently – get involved with one of these campaigns.

Learn more about May Measurement Month. If you would like to get involved in 2020 in any way, please contact the MMM Project Manager.

Neil Poulter is Professor of Preventive Cardiovascular Medicine and Director of the Imperial Clinical Trials Unit at Imperial College London, UK, and Chief Investigator for MMM.

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