Prevalence, Treatment, Control and Monitoring of Hypertension: A Nationwide Community-Based Survey in Taiwan, 2017

Abstract

Background: Inadequate awareness and control remain the major obstacles for hypertension management worldwide. This observational study intended to assess the current status of hypertension management in Taiwan.

Methods: The Taiwan May Measurement Month (MMM) campaign was a nationwide survey for public alertness to hypertension initiated in 2017 and conducted in local pharmacies. Participants were asked about body habitus, comorbidities, smoking/drinking, use of anti-hypertensive drugs, and frequency of self-measured blood pressure (SMBP) monitoring. Three blood pressure (BP) readings were then measured by trained pharmacists. The mean BP was obtained by averaging all readings.

Results: BP recordings were obtained from 49,522 participants (average age, 56.9 ± 16.0 years), of whom 26.1% had an elevated pharmacist-measured BP (≥ 140/90 mmHg). The rate of BP control, defined as pharmacist-measured BP < 140/90 mmHg at the MMM visit, was 63.1% among treated hypertensive participants (n = 21,410). Participants who had uncontrolled hypertension were associated with a higher body mass index, currently smoking/drinking, diabetes, and stroke. More active SMBP monitoring (≥ weekly) was more often implemented in the participants with advanced age and cardiovascular diseases. More active SMBP (≥ weekly) was associated with lower measured BP among treated hypertensive participants but not overall control rate (control rate: 56.4% for ≥ weekly vs. 55.8% for < weekly, p = 0.363).

Conclusions: In the Taiwan MMM 2017, the hypertension control rate surpassed 60% in treated hypertensive participants. Suboptimal BP control was related to cardiovascular risk factors and prior stroke. Treated hypertensives had a lower measured BP but similar hypertension control rate for more active versus less active SMBP.

Keywords: Blood pressure monitoring; Control; Cross-sectional studies; Hypertension; Prevention.

Figure 1

Flowchart of all participants entering the study of Taiwan MMM 2017. BP, blood pressure; SMBP, self-measured blood pressure.

Figure 2

Propensity-score matching of actual BP difference and percentages of hypertensives under control. DBP, diastolic blood pressure; SBP, systolic blood pressure; SMBP, self-measured blood pressure.