Hypertension Awareness, Treatment, and Control in Mexico: An Opportunistic Medical Student-led Blood Pressure Screening Campaign – A Cross-Sectional Study
Background: Hypertension is still a growing public health problem in Mexico. An estimated 151% increase in the number of individuals with hypertension is expected for 2050 if actions are not taken in the country. The aim of this study is to describe hypertension awareness, treatment, control and its associated factors in participants of an opportunistic medical student-led blood pressure screening campaign in Mexico.
Methods: A cross-sectional study, using convenience sampling was performed, including participants aged 18 years and older from 15 Mexican states. Each participant completed a questionnaire about risk factors and had three BP measurements taken. Hypertension was defined as ≥140/90 mmHg. Multiple imputation with linear regression was performed where data was missing.
Results: From a population of 2 545 participants, 623 (24.5%) participants had hypertension. Of those with hypertension, 81.9% had a previous diagnosis of hypertension and only 16.1% were not on medication at the time of screening; 61% were controlled, 121% were uncontrolled patients and 18% were not aware they had hypertension. High marginalization was found to have the biggest proportion of uncontrolled cases (33%), while the number of unaware hypertensives in very low marginalization states doubled the national figure. More than half the participants taking antihypertensive agents were on a single medication, achieving control in almost 8 in 10 patients.
Conclusion: It is important to continue making and supporting awareness raising campaigns in different settings across the country to generate more evidence and lead to better programs for improving hypertension detection in Mexico.
McEvoy JW, Daya N, Rahman F, Hoogeveen RC, Blumenthal RS, Shah AM, et al. Association of Isolated Diastolic Hypertension as Defined by the 2017 ACC/AHA Blood Pressure Guideline with Incident Cardiovascular Outcomes. JAMA. 2020;323(4):329–38.
Schwalm JD, McCready T, Lopez-Jaramillo P, Yusoff K, Attaran A, Lamelas P, et al. A community-based comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster-randomised controlled trial. Lancet. 2019;394(10205):1231–42.
Beaney T, Schutte AE, Tomaszewski M, Ariti C, Burrell LM, Castillo RR, et al. May Measurement Month 2017: an analysis of blood pressure screening results worldwide. Lancet Glob Health. 2018;6(7):e736–43.
Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2020;395(10226):795-808.
Zhou B, Danaei G, Stevens GA, Bixby H, Taddei C, Carrillo RM, et al. Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet. 2019; 394(10199):639–51.
Beaney T, Schutte AE, Stegiou GS, Borghi C, Burger D, Charchar F, et al. May Measurement Month 2019: The Global Blood Pressure Screening Campaign of the International Society of Hypertension. Hypertension. 2020. [Ahead of print].
Ruilope LM, Chagas AC, Brandao AA, Gómez R, Alcalá JJ, Paris JV, et al. Hypertension in Latin America: Current perspectives on trends and characteristics. Hipertens Riesgo Vasc. 2016;34(1):50–56.
Sudharsann N, Geldsetzer P. Impact of Coming Demographic Changes on the Number of Adults in Need of Care for Hypertension in Brazil, China, India, Indonesia, Mexico, and South Africa A Modeling Study. Hypertension. 2019;73(4):770–76.
Sahoo D, Gosai H, Sahoo U, Harsoda JM. Awareness and Practices of Non-Pharmacological Approaches for Management of Hypertension in a Geriatric Population. Int J Med Students. 2014;2(2):53–55.
Campos I, Hernández L, Pedroza A, Medina C, Barquera S. Hipertensión arterial en adultos mexicanos: prevalencia, diagnóstico y tipo de tratamiento, Ensanut MC 2016. Salud Publ Mex. 2018;60(3):233–43.
Consejo Nacional de Evaluación de la Política de Desarrollo Social. Índice de Rezago Social 2015: Presentación de resultados. [Internet]. CONEVAL; May 2016. [cited June 2020]. Available from: https://www.coneval.org.mx/Medicion/Documents/Indice_Rezago_Social_2015/Nota_Rezago_Social_2015_vf.pdf
Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, et al. Prevalence, Awareness, Treatment, and Control of Hypertension in Rural and Urban Communities in High-, Midle-, and Low-Income Countries. JAMA. 2013;310(9):959–68.
Ríos-Blancas MJ, Cahuana-Hurtado L, Lamadrid-Figueroa H, Lozano R. Cobertura efectiva del tratamiento de la hipertensión arterial en adultos en México por entidad federativa. Salud Publica Mex. 2017;59:154–64.
Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39:3021-3104.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines 2017. Hypertension. 2018;71:e13–115.
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberg ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):1376–1414.
Narkiewicz K, Maraglino G, Biasion T, Rossi G, Sanzuol F, Palatini P. Interactive effect of cigarettes and coffee on daytime systolic blood pressure in patients with mild essential hypertension. J Hypertens. 1995;13(9):965–70.
Gordon T, Kannel WB. Drinking and Its Relation to Smoking, BP, Blood Lipids, and Uric Acid. Arch Intern Med. 1983;143:1366–74.
Beany T, Burrell LM, Castillo RR, Charchar FJ, Cro S, Damasceno A, et al. May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension. Eur Heart J. 2019;40(25):2006–17.
Landi F, Calvani R, Picca A, Tosato M, Martone AM, Ortolani E, et al. Body Mass Index is Strongly Associated with Hypertension: Results from the Longevity Check-Up 7+ Study. Nutrients. 2018;10:1976.
Devaux M, Graf S, Goryakin Y, Cecchini M, Huber H, Colombo F. Obesity Update 2017. [Internet]. The Organisation for Economic Co-operation and Development; 2017. [cited June 2020]. Available from: https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf
Castilla-Guerra L, Fernandez-Moreno MC. Chronic Management of Hypertension after Stroke: The Role of Ambulatory Blood Pressure Monitoring. J Stroke. 2016;18(1):31–37.
Ohta Y, Tsuchihashi T, Ibayashi S, Matsumura K, Kitazono T, Ooboshi H, et al. Blood Pressure Control in Hypertensive Patients With a History of Stroke. J Stroke Cerebrovasc. 2005;14(6):229–33.
Konstantinou K, Tsioufis C, Koumelli A, Mantzouranis M, Kasiakogis A. Doumas M, et al. Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective. J Clin Hypertens. 2019;21(8):1135–43.
Varshney VP, Harrison T, Szymczakowski M, Grossi M, Jones C. Developing a Protocol for Medical Student-Organized Community-Based Hypertension Screening Programs. Int J Med Students. 2013;1(1):8–11.
Copyright (c) 2020 José Adrián Yamamoto-Moreno, Suzzette Anaís Navarro-Rodríguez, Samuel Ruiz-Pérez, Juan Carlos Godínez-Reyes, Marvin Mendoza-Rojo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to firstname.lastname@example.org
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to email@example.com