Search

The Cabo Verdean population is aging and, consequently, non-communicable diseases, namely cardiovascular diseases, are increasing, with hypertension being an important risk factor. Following Cabo Verde's engagement with the May Measurement Month (MMM) campaign, in 2019, it was possible to improve the screening capacity, at the same time that a major social mobilization campaign was carried out to improve the population's knowledge about raised blood pressure (BP) and its consequences. With activities on nine islands, telemedicine was used to train researchers and volunteers. The MMM app was used to collect participant data. Individuals aged ≥18 years were recruited through opportunistic sampling. Each participant completed a questionnaire on demographic, lifestyle and environmental factors and had three BP measurements and weight and height measurements. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg (mean of the second and third readings), or when using antihypertensive medication. When respondents did not provide three BP readings, multiple imputation using chained equations was used to calculate the mean of the second and third readings. A total of 17 627 individuals [mean age of 42.7 (SD 16.2); 63.8% women] were screened. After multiple imputation, 5990 (34.0%) had hypertension, of which 68.4% knew the diagnosis previously and 51.3% used antihypertensive drugs. The reported use of antihypertensive medication and a previous diagnosis of hypertension were strong predictors of higher levels of systolic and diastolic BP. Corrective actions were taken with an updated national protocol for hypertension treatment in primary health care. The II Non-Communicable Diseases Survey corroborated MMM national data that we see as an ideal initiative to reach the public, raising awareness about this important cardiovascular risk factor and providing political decision instruments.

Raised blood pressure (BP) is the biggest contributor to mortality and disease burden in Cabo Verde. May Measurement Month (MMM) is a global campaign set up in 2017 to raise awareness of high BP. In 2018, we aimed to expand the campaign by including a greater number of centres to increase awareness. Nine islands participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 98.0% of screenees provided three BP readings and multiple imputation using chained equations was used to impute missing readings. A total of 8008 individuals (mean age 40.4 years; 68.5% female) were screened. After multiple imputation, 2666 (33.3%) individuals had hypertension, of whom 74.8% were aware of their previous diagnosis and 55.8% were taking antihypertensive medication. Of those on medication, 39.1% were controlled and of all hypertensives, 21.8% were controlled. We detected 44.2% of individuals with untreated hypertension and 60.9% of treated individuals were inadequately treated. The Cape Verdean population is ageing and consequently cardiovascular disease is increasing, with hypertension being an important risk factor. Corrective actions need to be taken by the government. MMM is an ideal initiative to reach the public by raising awareness of this major cardiovascular risk factor.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. Cabo Verde is in an epidemiological transition, with replacement of infectious diseases by chronic diseases, and the major cause of morbidity/mortality is cardiovascular disease which caused 28.9% of the total deaths in 2016. The only data we have are from 2007—the Ministry of Health and Social Security used a study STEP approach in which the prevalence of hypertension was 35%. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017 (MMM17). Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. A total of five islands and eight centres, including hospitals and local health centres participated in this study, with about 20 volunteers/investigators. A total of 2630 individuals were screened during MMM17. After multiple imputation, 760 (29.0%) had hypertension defined as being on BP lowering treatment or having a BP ≥140/90 mmHg. Of individuals not receiving anti-hypertensive medication, 232 (11.1%) were hypertensive. Of 522 individuals receiving anti-hypertensive medication with an available BP, 225 (43.1%) had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Cabo Verde. The proportion of hypertensives in the population in study was 29.0%, with most of these on treatment, and 43.1% of those on treatment with uncontrolled hypertension. These results suggest that opportunistic screening can identify significant numbers with raised BP.

Resumo: A meta da Organização Mundial da Saúde de reduzir a mortalidade por doenças crónicas não transmissíveis em 2% ao ano exige um enorme esforço por parte dos países. Esse grande desafio lançado pela Organização Mundial de Saúde requer uma ação política global e concertada através de medidas nas comunidades, com intervenções populacionais de cunho custo‐efetivo para reduzir prevalência das doenças crónicas não transmissíveis e dos seus fatores de risco. A hipertensão arterial tem grande prevalência nas populações dos países de língua portuguesa e representa o principal fator de risco para complicações como acidente vascular cerebral, enfarte agudo do miocárdio e doença renal crónica, correspondendo em importância à dislipidemia e obesidade para as doenças ateroscleróticas. Ações conjuntas que visem à implementação de medidas de prevenção primária poderão reduzir os desfechos relacionados com a doença hipertensiva, especialmente acidente vascular cerebral e enfarte agudo do miocárdio. Torna‐se necessário garantir a implementação dessas diretrizes para o tratamento da HTA no terreno, através de um processo continuado, que envolva fundamentalmente ações de educação, de mudança do estilo de vida e garantia de acesso aos medicamentos. Abstract: The World Health Organization goal's to reduce mortality due to chronic non‐communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost‐effective population interventions to reduce chronic non‐communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese‐speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment. Palavras‐chave: Hipertensão/complicações, Doença crónica/mortalidade, Dislipidemias, Obesidade, Comunidade dos Países de Língua Portuguesa, Keywords: Hypertension/complications, Chronic disease/mortality, Dyslipidemias, Obesity, Community of Portuguese Language Countries

The World Health Organization goal's to reduce mortality due to chronic non-communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost-effective population interventions to reduce chronic non-communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese-speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment. Resumo: A meta da Organização Mundial da Saúde de reduzir a mortalidade por doenças crônicas não transmissíveis em 2% ao ano exige um enorme esforço por parte dos países. Esse grande desafio lançado pela Organização Mundial de Saúde requer uma ação política global e concertada através de medidas nas comunidades, com intervenções populacionais de cunho custo-efetivo para reduzir prevalência das doenças crónicas não transmissíveis e dos seus fatores de risco. A hipertensão arterial tem grande prevalência nas populações dos países de língua portuguesa e representa o principal fator de risco para complicações como acidente vascular cerebral, enfarte agudo do miocárdio e doença renal crónica, correspondendo em importância à dislipidemia e obesidade para as doenças ateroscleróticas. Ações conjuntas que visem à implementação de medidas de prevenção primária poderão reduzir os desfechos relacionados com a doença hipertensiva, especialmente acidente vascular cerebral e enfarte agudo do miocárdio. Torna-se necessário garantir a implementação dessas diretrizes para o tratamento da HTA no terreno, através de um processo continuado, que envolva fundamentalmente ações de educação, de mudança do estilo de vida e garantia de acesso aos medicamentos. Keywords: Hypertension/complications, Chronic disease/mortality, Dyslipidemias, Obesity, Community of Portuguese Language Countries, Palavras-chave: Hipertensão/complicações, Doença crônica/mortalidade, Dislipidemias, Obesidade, Comunidade dos Países de Língua Portuguesa

Introducao A meta da Organizacao Mundial da Saude (OMS) de reduzir a mortalidade por doencas cronicas nao transmissiveis (DCNT) em 2% ao ano demanda um enorme esforco dos paises.– Esse grande desafio dos profissionais de saude requer uma acao politica global atraves do controle pelas medidas sociais, com intervencoes populacionais de cunho custo-efetivo para reduzir as DCNT e seus fatores de risco (FR). Aos profissionais de saude cabe a exigencia ao governo de implementacao de medidas com custo aceitavel, como [...]