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This article describes the May Measurement Month (MMM) 2021 campaign, which was the fourth time this annual hypertension screening campaign was conducted in Albania, a Mediterranean country in southeastern Europe. The MMM21 was conducted during the period of 28 September-30 November 2021, in 32 sites across several districts of Albania. Overall, 11 788 participants aged ≥18 years were included (63% women), with a mean age of 49.7 ± 14.9 years. Blood pressure (BP) was measured three times with Omron sphygmomanometers (model M3, Omron Healthcare, Kyoto, Japan), which are automatic upper arm BP monitors. Hypertension was defined as SBP ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg (based on the mean of the second and third recordings for SBP and DBP, respectively) or on antihypertensive medication. Self-reported data included pre-existing conditions, physical activity, smoking, alcohol consumption, COVID-19 testing, and use of contraception in women. Overall, 47.3% of screened participants had hypertension. Of those with hypertension, 70.1% were aware of their condition and 67.0% were on antihypertensive medication. About half (49.3%) of participants on antihypertensive medication had controlled BP (<140/90 mmHg). On average, BP was higher in those on antihypertensive medication and with increasing alcohol intake but lower in those with a history of stroke and those with higher levels of physical activity, previous positive COVID-19 test, and contraception use in women. In Albania, the MMM campaign continues to contribute to the early detection of hypertension among adults. Hence, it constitutes a valuable opportunistic screening instrument among other routine tools applied in the general Albanian population.

There is a need to constantly assess the awareness, treatment, and control of hypertension in Nigeria. This study determined the frequency of undiagnosed hypertension across the six geopolitical zones of Nigeria. We conducted an opportunistic screening of adults aged at least 18 years in the month of May 2021. Participants were recruited by trained volunteers using the May Measurement Month protocol. Blood pressure (BP) was measured using validated digital sphygmomanometers. We defined hypertension as systolic BP ≥ 140 and/or diastolic BP ≥ 90 mmHg and/or the use of BP-lowering medications. A total of 9361 participants (51.5% females) with a mean age of 40.7 ± 15.5 years were screened. Hypertension was present in 3192 (34.1%) of the participants. About half (1491, 46.7%) of the hypertensives were unaware of the diagnosis. Among the 3192 participants with hypertension, less than half (1540, 48.2%) were on antihypertensive medications, while only 36.4% of those on antihypertensive medications had their BP controlled (<140/90 mmHg). About one-third of Nigerians in this opportunistic screening had hypertension, with about half of them being unaware of their diagnosis while only about two out of every five on antihypertensive medications had controlled BP. Urgent health actions are needed in Nigeria to reduce the burden of hypertension and its complications.

The May Measurement Month 2021 campaign in Zimbabwe was aimed at assessing the frequency of hypertension and improving awareness among the population of the sequelae of elevated blood pressure (BP). Participants aged 18 years and above were recruited at outdoor booths to fill out a questionnaire and provide three BP measurements with 1-min intervals. Of the 2094 participants, over one-third (37.3%) were hypertensive, half of hypertensives (49.7%) were aware they had elevated pressure, and less than half (45.0%) of the hypertensive patients were on antihypertensive medications. Increasing age was directly proportional to hypertension with a large leap from 9.5 to 27.7% between the 18-29 and 30-39 age groups. Hypertension remains a major public health challenge in Zimbabwe. Improving access to preventive health screening services as well as treatment facilities is essential to early detect and control hypertension.

May Measurement Month (MMM) is a global campaign initiated by the International Society of Hypertension (ISH) with the aim of raising awareness of high blood pressure (BP) and serving as a catalyst for the establishment of screening programmes around the world. An opportunistic cross-sectional survey of volunteers aged ≥18 years was conducted. A standardized protocol for MMM was used to measure BP and collect relevant health information from participants at screening sites in four regions of Ghana. Hypertension was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or on antihypertensive medication. A total of 4832 people agreed to take part in the MMM21 study and were screened. After multiple imputation of missing BP readings, 1426 people (29.5%) had hypertension. 11.9% of the 1426 participants with hypertension were aware of their condition, and 8.6% reported taking antihypertensive medication. 24.2% of 123 people on antihypertensive medication had their BP under control (<140/90 mmHg). In addition, only 2.1% of the 1426 participants with hypertension had controlled BP. Results from this study found that almost nine out of 10 people with hypertension who were screened were unaware of their condition, most were untreated, and only 2% of those with hypertension had their BP controlled with medication. This emphasizes the importance of BP screening campaigns as a tool for identifying and referring people with high BP for treatment.

Elevated blood pressure (BP) is the most important risk factor for cardiovascular diseases (CVDs), which are still the leading cause of mortality in Hungary. Therefore, screening programmes identifying subjects with hypertension have an important role in CVD prevention. In 2017, the International Society of Hypertension initiated May Measurement Month (MMM) aimed at raising awareness of elevated BP. Hungary joined the MMM campaigns in 2017, 2019, and 2021, and a summary of the results from 2021 is presented here. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in September 2021. Measurement of BP, the definition of hypertension, and statistical analysis followed the standard MMM protocol. In Hungary, 30 sites were set up in primary and secondary care facilities, in pharmacies, and in malls. Both cities and villages were involved in all regions. A total of 1414 individuals were screened, and 558 subjects (39.5%) had hypertension. Out of 1065 participants not on antihypertensive medication, 209 (19.6%) had elevated BP. Among treated individuals (n = 349), 206 (59.0%) had controlled BP (<140/90 mmHg). Almost 40% of the participants had hypertension. Among untreated participants, one in five had elevated BP, while among patients on antihypertensive medication, 41% had uncontrolled BP. These results confirm the importance of screening of hypertension in untreated individuals and that efforts are required to adequately control BP in treated hypertensive patients.

We reported findings from participants screened during the May Measurement Month 2021 in China, which aimed to raise awareness of raised blood pressure (BP), and to investigate the risk factors of BP. The study participants were adults (≥18 years), ideally in whom BP had not been measured in the previous year. Blood pressure was measured three times consecutively with 1 min intervals in the sitting position, using a validated upper-arm cuff automated BP monitor (Omron HEM-7081IT), and transmitted to a central cloud database via a smartphone app. The measurement was performed in 218 844 participants in 183 sites across 31 China provinces. The mean (standard deviation) age was 47.0 (15.7) years, and 51.8% (n = 113 466) were women. The mean systolic/diastolic BP was 120.2/77.5 mmHg. Among 57 178 (26.1%) participants with hypertension, the awareness, treatment, and control rates of hypertension were 30.4% (n = 17 354), 28.7% (n = 16 369), and 17.1% (n = 9743), respectively. After adjustment for age, sex, and use of antihypertensive medication, both systolic and diastolic BP were significantly (P ≤ 0.01) higher in current smokers (n = 22 344, +0.4/+0.7 mmHg) and with moderate (n = 4780, +1.4/+4.2 mmHg) or daily alcohol intake (n = 2427, +1.3/+2.5 mmHg). Blood pressure was lower in those reporting regular exercise (n = 32 328, -2.2/-1.4 mmHg). In addition, individuals with previous COVID-19 vaccination had lower systolic and diastolic BP (n = 88 945, -1.8/-1.5 mmHg, P ≤ 0.001). In conclusion, our study showed that long-term large-scale screening for hypertension is feasible, and there is a strong association between BP and major lifestyle factors.

May Measurement Month 2021 (MMM21) is the fourth edition of the global initiative in Poland initiated by the International Society of Hypertension (ISH) and aimed at raising awareness of hypertension and the need for blood pressure (BP) screening. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 132 sites - between May and September 2021. Blood pressure was measured in 1699 subjects (mean age: 40.8 ± 17.0 years; 68.8% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.6/78.7 mmHg for the entire group, 133.8/81.9 mmHg in individuals on antihypertensive medication, and 125.4/78.6 mmHg in those not taking antihypertensive drugs. The proportion of subjects with high BP (≥140/90 mmHg) were: 30.9% for the entire group, 40.4% in subjects taking antihypertensive drugs, and 17.9% in those not taking antihypertensive drugs. Of all participants, 33.9% were in the age range of 18-29 years and we observed higher BP levels and more frequent BP elevation in males in this age group. These data provide unique insights into the hypertension rates during the COVID-19 pandemic. Due to the associated restrictions, only limited data could be obtained for older adults. Interestingly, among young Polish participants, the rate of hypertension and the level of BP were higher in males compared to females, suggestive perhaps of a higher susceptibility of males to experience a rise in BP during specific circumstances associated with a pandemic.

The Philippine Society of Hypertension (PSH) took part again in the annual May Measurement Month 2021 (MMM21) blood pressure (BP) campaign to raise awareness of hypertension. The MMM standard protocol designed by the MMM coordinating centre was used during screening. These included the collection of basic data on demography, lifestyle, and environmental factors. Standardized sitting BP measurements were taken three times, using automated BP apparatus and were either entered via MMM21 app, MMM@Home, and Google Forms or recorded on paper and transferred to Excel spreadsheets by PSH encoders. Hypertension was defined either as systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or on antihypertensive medication. A total of 59 655 participated through opportunistic convenience sampling. After multiple imputation, a total of 26 813 (44.9%) participants were identified as having hypertension. Of these, 14 449 (53.9%) were aware and 12 978 (48.4%) were on antihypertensive medication. Of those who were treated, 5644 (43.5%) had controlled BP (<140/90 mmHg) and 7334 (56.5%) were uncontrolled. These latest local data showed that BP awareness is still low with BP control achieved in less than half of treated patients. Continued collaboration is needed to improve BP screening programmes in the country.

High blood pressure (BP) is the leading cause of cardiovascular disease in Uganda accounting for more than 50% of cardiovascular related deaths each year. In Uganda, more than 25% of adults have high BP with lack of awareness being the main barrier to achieving satisfactory control rates. 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 BP screening programmes. A cross-sectional survey of voluntary screenees aged 18 years and above was carried out between May and September 2021. Screening was carried out in two outpatient departments of two referral hospitals within the capital city, Kampala. BP measurements, the definition of hypertension and statistical analysis followed the standard MMM protocol. A total of 1671 people were screened and included in analysis. After multiple imputation, 1018 (60.9%) had hypertension. Of all 1018 participants with hypertension, 765 (75.1%) were aware and 750 (69.3%) were on antihypertensive medicine. Of the participants on antihypertensive medicine, 248 (35.2%) had controlled BP (<140/90 mmHg). Previous history of stroke and taking alcohol 1-6 times per week were significantly associated with higher diastolic BP. The MMM21 Uganda campaign highlights the importance of measuring BP as it generates real-time data on untreated and inadequately treated hypertension. This should motivate government and policy makers to promote routine local screening for BP.

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 to raise awareness of high BP and acts as a temporary solution to the worldwide shortage of screening programmes. We aimed to screen for hypertension and cardiovascular risk factors in people aged ≥18 years in the community, thereby defining the proportion of participants with elevated BP and assessing the awareness and the effectiveness of its treatment. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2021. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. From May 2021 to June 2021, through three cities/provinces in Vietnam (due to the COVID-19 pandemic), 2572 individuals with mean age 51.5 (SD ±15.7) years were screened. After multiple imputation, 929 (36.1%) had hypertension. Of individuals not receiving antihypertensive medication, 206 (11.2%) were hypertensive. Of individuals receiving antihypertensive medication, 415 (57.4%) had uncontrolled BP (≥140/90 mmHg). The MMM21 BP screening campaign was undertaken in Vietnam during the COVID-19 pandemic. Undiagnosed and uncontrolled hypertension in Vietnam remains a substantial health problem. Local campaigns applying standardized methods such as MMM21 will be beneficial to screen for a significant number of individuals with raised BP and increase awareness of hypertension.