Background
Blood pressure (BP) control plays a pivotal role in reducing stroke incidence and recurrence. May Measurement Month (MMM) is the largest global BP screening campaign, initiated in 2017 by the International Society of Hypertension (ISH). We aim to compare MMM participants with and without a previous stroke and to investigate associations between national-level estimates of BP management from MMM and premature stroke mortality.
Methods
Over 2.5 million volunteers (≥18 years) were screened in May 2017 and 2018 from 92 countries. Three seated BPs and demographic, lifestyle, and cardiovascular disease data were collected. Associations between risk factors and stroke history were analysed using mixed-effects logistic regression. Linear regression was used to investigate associations between national-level estimates of BP management and premature stroke mortality based on Global Burden of Diseases (GBD) data.
Findings
Of 2 222 399 (88·4%) participants with recorded data on a history of stroke, 62 639 (2·8%) reported a previous stroke. Those with a stroke history had higher rates of hypertension and treated and controlled hypertension than those without. One third of those with a stroke history had untreated or treated but uncontrolled BP (≥140/90 mmHg). Strong positive associations were found between national premature stroke mortality and increasing mean systolic BP levels and proportion of participants with raised BP and strong negative associations with the proportions of hypertensives on treatment and with controlled BP.
Interpretation
BP control remains suboptimal worldwide amongst those with a previous stroke. National estimates of BP management reflect national premature stroke mortality sufficiently well to provide a prompt for policymakers to promote BP screening and management.