BLOOD PRESSURE AWARENESS, TREATMENT AND CONTROL IN PEOPLE WITH DIABETES: RESULTS FROM THE GLOBAL MAY MEASUREMENT MONTH (MMM) CAMPAIGNS 2017-2022

Objective: Diabetes and hypertension, both risk factors for cardiovascular complications, frequently coexist, amplifying the overall burden of cardiovascular disease. May Measurement Month (MMM) is an annual global blood pressure (BP) screening campaign raising awareness of BP measurement since 2017. People with diabetes should have their BP checked regularly and commence BP-lowering medication if appropriate. The aim of the study was to explore how awareness, treatment and control varies globally between participants with and without diabetes in MMM. Design and method: Adult individuals were recruited in annual screenings between 2017 and 2022 in 92 countries. Each participant had three sitting BP measurements, and a questionnaire was completed including demographics, comorbidities (including self-reported diabetes) and lifestyle factors. Hypertension was defined as systolic BP 140 mmHg or higher and/or diastolic BP 90 mm Hg or higher (average of the second and third readings) or taking antihypertensive medication. Uncontrolled hypertension was defined as systolic BP 140 mmHg or higher and/or diastolic BP 90 mmHg or higher in those on antihypertensive medication. Results: Of 5,381,283 screened, 4,109,420 had the second and third BP readings recorded and were included in analysis. Of those, 302,060 (7.2%) had diabetes. Participants with self-reported diabetes were twice as likely to have hypertension than those without diabetes (65.4% vs 32.1%, p<0.001). Of those with hypertension, participants with diabetes were more likely to be aware of their hypertension (83.9% vs 55.6% p<0.001), more often on antihypertensive medication (81.4% vs 52.5%, p<0.001), and more likely to be controlled (46.4% vs 29.2%, p<0.001). However, of those on antihypertensive medication, there was only a small difference in the control rates in those with and without diabetes (56.9% vs 55.7%p<0.001). Conclusions: People with diabetes and hypertension were more likely to be aware and treated than those without diabetes, but still almost one in five were unaware and untreated and control rates remained poor. Although reporting a diabetes diagnosis related to better hypertension management, there is still room for improvement for people with diabetes to reduce their BP and cardiovascular risk, given those with diabetes remain a high-risk group for cardiovascular complications.