MMM 2017 BLOOD PRESSURE SCREENING IN VIETNAMESE

ADULTS

HUYNH VAN MINH, MD, PhDVIETNAM SOCIETY OF HYPERTENSION

Driven by ISH

Supported at country level

Thank you to our supporters

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Introduction

M Mohsen Ibrahim, Albertino Damasceno Vol 380 August 11, 2012

Classification of HTN following the income levels

Whole country-Health statistics Yearbook- VN MOH

TREND OF MORTALITY BY CATEGORY

( % )

0

10

20

30

40

50

60

70

80

1976 1986 1996 2006 2011

C.D

N-C.D

Acc,Inj,pois

Reality & problems of Vietnam:Hypertension & Heart disease; We do this. Pham Gia Khai, VNHA

Prevalence of HTN in South East Asia

AND SO MMM17 WAS BORN

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Aims of presentation

• To anounce the results of Vietnamhypertension screening through MMM2017such as prevalence, risk factors, awareneesand treatment .

• To compare with our 5 previous years dataand those of Asian hypertensive persons.

Materials and Methods• In this cross-sectional study, in 10 cities and

provinces from 13/5/2017 to 29/5/2017

• 10.993 person ≥ 18 years old who had not

checked their BPs for at least a year before the

recruitment.

Have not had

BPs measured

for at leat

a year

Consent for

Participation

given

18age years

Everyone was tested, but only those who met the three criteria of ISH were included in the study

East Sea

BanMe

Thuot

1. Hanoi /3.701

2. Vinh/1.497

3. ThanhHoa/488

4. Hue/1.906

5. QuiNhon/705

6. TuyHoa/699

7. BanMeThuot/324

8. CanTho/543

9. HochiMinh/1.130

Total: 10.993 Tuy Hoa

The selected cities / No of participants

Device of BP measurement

• automated electronic device.

• some special cases with asphygmomanometer.

● Being on at least 1 antihypertensive medication taken for raised BP or

● The average SBP (mean of the last 2 of 3 readings) ≥ 140 mmHg and/or the average DBP (mean of the last 2 of 3 readings) ≥ 90 mmHg

Definition of hypertension

Rule of BP measurement•Measure the circumference of the arm (at the mid arm level) and ensure that the correct size of arm cuff is used•The cuff should be placed at the heart level

•The patient’s arm being used for the measurement should rest comfortably on a table

•BP should be measured on one arm only, preferably left, and the arm used should berecorded

•The participant should be seated with their backs supported and with their legs resting on the ground and in the uncrossed position for 5 min

•Should not have smoked immediately before or during the measurement

ACTIVITIES OF PREPARATION

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RECRUITMENT FOR THE SCREENING

THE SUPERMARKET…

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EVEN, THE FACTORY………..

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Characteristics of Participants*

Gender Female Male Unknown

6770 (61,6%) 4217(38,4%) * 6 (0,1%)

Age (years) Mean ± SD 49.1±16.2

Ethnicity Kinh Other

8.225 (91,1%) 1088 ( 9,9%) *

On antihyperten

sivesNo Yes Unknown

medication 9338 (84,9%) 1645 (15,0%)* 10(0,1%)

Diabetes No Yes Unknown

9736 (88,6%) 599( 5,5%) * 658( 6,0%)

Curent smoker No Yes Unknown

9468 (86,1%) 1514(13,8%)* 11 (0,1%)

Alcohol intake Rarely ≥ 1 per week Unknown

10245 (93,2%) 735 (6,7%) 13 (0,1%)

BMI (kg/m2) Mean ± SD 22.1 ± 3.0

Total participants 10993 100,0%

* p< 0,05 , Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

Crude and age/sex-standardised BP measurements

after imputation,

using WHO world standard populations*

Crude

BP

Age and sex

standardised

BP

Age and sex

standardised

BP excluding

those on

treatment

Age and sex

standardise

d BP in

those on

treatment

SBP(mmHg) 121,2 120,2 119,4 130,2

DBP(mmHg) 75,8 75,6 75,1 81,1

Denominator 8982 10969 9327 1642

* Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

Trends of BP in Vietnamese adults*

* Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

Change BP with individual characteristics*

* Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

Change blood pressure with Body Mass Index (BMI)*

* Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

Coorelation between BMI and Blood Pressure

r=0,214(p<0,001), DBP= 57,763+ 0,828x BMI r=0,211 (p<0,001), SBP= 91,811 + 1,369 x BMI

0

5

10

15

20

25

30

Normal High-normal Hypertension

Smoke

Alcohol

Obese

Relationship between risk factors for smoking, alcohol and obesity with hypertension.

The most common risk factors were smoking (17.5%), alcohol (13.3%) and obesity (12.7%), which accounted for high propotion of hypertension.

Results from linear regression models adjusted for age,

sex and antihypertensive treatment after amputation*

Participa

nts with

HTN

%Denomi

nator

Participants

with HTN and

not receiving

treatment

%Denomi

nator

Participants

receiving

treatment but with

uncon

trolled BP

%Denomin

ator

3154 28,7 10989 1509 16,1 9344 620 37,7 1643

* Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

28.70%

16.10%

37.70%

HTN Not treatedfor HTN

Treated butuncontrolled

Hypertensive target organ followingMMM 2017 BP screening in Vietnamese adults

Previous MI

No 10520 95,7%

Yes 469 4,3%

Unknown 4 <0.1%

Previous stroke

No 10872 98,9%

Yes 120 1,1%

Unknown 1 <0.1%

* Excel analysis were offered by Xin Xia and Elsa Kobeissi, MMM statistic team

Discussion

A TRULY GLOBAL CAMPAIGN

100 countries participated 1.2 million data sets collected

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NATIONAL PROGRAM OF PREVENTION - CONTROL OF

HYPERTENSION

Prevalence of hypertension in Vietnam

- 1960: Dang Van Chung et al.: Hypertension among adult population in Northern Vietnam.

- 1992: Tran Do Trinh et al.: Hypertension among Vietnamese people aged 18 years and over.

- 2002: Truong Viet Dung et al.: Hypertension among Vietnamese adults aged 25 to 64 years old.

National Health Survey 2001 – 2002.

- 2008: Our survey.: Hypertension and its risk factors among Vietnamese adults aged 25 years and over.

Vietnam National Survey of HTN in 2012

Son PT et al. J Hum Hypertens 2012;26(4):268-80.

196219141900

1766

1416

0

500

1000

1500

2000

2500

3000

3500

1 2 3 4 5

Heart Failure Hypertension Ischemic heart disease

Rheumatic heart disease Congenital heart desease Pericardial disease

Arrhythmia Cardiomyopathies Endocarditis

Cerebrovascular disease PAD DVT

Trends of absolute numbers of HTN and CVD in Vietnam

2003 2004 2005 2006 2007

Reality & problems of Vietnam:Hypertension & Heart disease; We do this. Pham Gia Khai, VNHA

Complications of HTN in Vietnam

• In nationwide hospital-based statistics : 3rd/10

most encountered diseases : 317.6/100,000

• Death related to Hypertension : Nationwide :

- Intracerebral haemorrhage : 6th rank (of 10)

0.74/100,000

- Acute myocardial infarction : 7th rank (of 10)

0.69/100,000

Nguyen NQ et al. Int J Hyperten 2012 doi:10.1155/2012/560397

Prevalence of HTN in developing countries

40

35

30

25

20

15

10

5

0

26,3 33,1 31,7 24

36,9

32 32,5

20,5

16

35,3 33,7

25,1

M Mohsen Ibrahim, Albertino Damasceno Vol 380 August 11, 2012

Awareneess & capacity of HTN control

in developing countries & developed countries

IN CONCLUSION

The MMM program has made a big impact on the awareness of hypertension among people in particular in Vietnam.

Although there were still many organizational limitations and the number of participants was still modest, MMM can be said to have been the most successful operation in Vietnam.

Hopefully, the upcoming ISH plan might help improve hypertension situation in Vietnam as well as in the world ./.

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