Global impact of different blood pressure thresholds in 4 021 690 participants of the May Measurement Month initiative

File Description SizeFormat 
MMM_HTN_DEFs_JMN_1_14.docxFile embargoed until 16 November 2022164.27 kBMicrosoft Word    Request a copy
Title: Global impact of different blood pressure thresholds in 4 021 690 participants of the May Measurement Month initiative
Authors: Nolde, JM
Beaney, T
Carnagarin, R
Schutte, AE
Poulter, NR
Schlaich, MP
Item Type: Journal Article
Abstract: BACKGROUND: Influential guidelines currently define hypertension at different thresholds of blood pressure (BP). The global May Measurement Month initiative provides a unique opportunity to estimate the potential consequences of universal lowering of BP thresholds on the prevalence of hypertension based on a large, real-world, patient-level data set. METHODS: The average of the second and third of 3 attended BP readings after 5 minutes of rest from 4 021 690 standardized, opportunistic BP screenings in various settings of the 2017 to 2019 May Measurement Month initiatives from 104 countries were analyzed to assess the demographic and phenotypic impact of 3 defined BP thresholds. RESULTS: The age- and sex-standardized median of the relative increase in rate of hypertension with a change of thresholds from ≥140/≥90 to ≥130/≥80 mm Hg was 72.3% (interquartile range, 59.3%-91.3%) among the participating countries. With a change from ≥140/≥90 to ≥120/≥70 mm Hg, the median range was 162.6% (interquartile range, 132.8%-202.6%). The increase in rate of hypertension was most pronounced in low-income (95.3% and 203.9%) and least pronounced in high-income countries (71.6% and 167.1%). CONCLUSIONS: The impact of a universal application of lower BP thresholds for the definition of hypertension would have an enormous impact on the prevalence of hypertension globally with large disparities between countries and substantial heterogeneity of demographic and phenotypic patterns, which should be confirmed in dedicated population studies. While focusing on lower BP targets may constitute an opportunity for early intervention, the potential socioeconomic consequences may pose unsurmountable obstacles for most health care systems worldwide.
Issue Date: 1-Jul-2022
Date of Acceptance: 5-Apr-2022
URI: http://hdl.handle.net/10044/1/97502
DOI: 10.1161/HYPERTENSIONAHA.122.19144
ISSN: 0194-911X
Publisher: American Heart Association
Start Page: 1497
End Page: 1505
Journal / Book Title: Hypertension
Volume: 79
Issue: 7
Copyright Statement: © 2022 American Heart Association, Inc.
Keywords: cardiovascular diseases
epidemiology
hypertension
prevalence
socioeconomic factors
cardiovascular diseases
epidemiology
hypertension
prevalence
socioeconomic factors
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status: Published
Conference Place: United States
Embargo Date: 2022-11-16
Online Publication Date: 2022-05-17
Appears in Collections:School of Public Health