Bài giảng MMM 2017 blood pressure screening in Vietnamese adults

MMM 2017 BLOOD PRESSURE
SCREENING IN VIETNAMESE
ADULTS
HUYNH VAN MINH, MD, PhD
VIETNAM SOCIETY OF HYPERTENSION


Driven by ISH

Supported at country level

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Introduction


Classification of HTN following the income levels

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


TREND OF MORTALITY BY CATEGORY
( %)
80
70

60
50

C.D
N-C.D
Acc,Inj,pois

40
30
20
10
0
1976

1986

1996

2006

2011

Whole country-Health statistics Yearbook- VN MOH
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 Vietnam
hypertension screening through MMM2017
such as prevalence, risk factors, awarenees
and treatment .
• To compare with our 5 previous years data
and 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.

age  18 years

Have not had
BPs measured
for at leat
a year

Consent for
Participation
given
Everyone was tested, but only those who
met the three criteria of ISH were included in the study
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The selected cities /
No of participants
1.
2.
3.
4.
5.
6.
7.
8.
9.

Hanoi /3.701
Vinh/1.497
ThanhHoa/488
Hue/1.906
QuiNhon/705
TuyHoa/699
BanMeThuot/324
CanTho/543

HochiMinh/1.130
Total: 10.993

BanMe
Thuot

Tuy Hoa

East Sea

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Device of BP measurement
•
•

automated electronic device.
some special cases with a
sphygmomanometer.

Definition of hypertension
● 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


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 be
recorded
•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

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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
6770 (61,6%)
Mean ± SD
Kinh
8.225 (91,1%)

Age (years)
Ethnicity
On antihyperten
sives
medication
Diabetes

No

9338 (84,9%)
No
9736 (88,6%)
Curent smoker
No
9468 (86,1%)
Alcohol intake
Rarely
10245 (93,2%)
BMI (kg/m2)
Mean ± SD
Total participants

* p< 0,05 ,

Male
Unknown
4217(38,4%) *
6 (0,1%)
49.1±16.2
Other
1088 ( 9,9%) *
Yes

Unknown

1645 (15,0%)*

10(0,1%)
Yes
Unknown
599( 5,5%) *
658( 6,0%)
Yes
Unknown
1514(13,8%)*
11 (0,1%)
≥ 1 per week
Unknown
735 (6,7%)
13 (0,1%)
22.1 ± 3.0
10993
100,0%

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


Relationship between risk factors for smoking, alcohol
and obesity with hypertension.
30
25
20

Smoke

15

Alcohol

10

Obese

5
0
Normal

High-normal

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

3154

28,7

10989

1509

%

16,1

Participants
receiving
Denomi
treatment but with
nator
uncon
trolled BP
9344

620

%

Denomin
ator

37,7

1643

37.70%
28.70%
16.10%

HTN

Not treated
for HTN

Treated but
uncontrolled

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