May Measurement Month 2023: results of an opportunistic blood pressure screening campaign in Bulgaria

Abstract The May Measurement Month (MMM) campaign was conducted in Bulgaria in 2023 to raise awareness of raised blood pressure (BP). Adults aged ≥18 years were recruited through convenience sampling at 162 screening points in medical centers, pharmacies, and outdoor spaces across 23 administrative districts. The average of the second and third seated BP readings were taken on each participant and a questionnaire collected information on demographics, lifestyle factors, and comorbidities. Hypertension was defined as a systolic BP ≥140mmHg or diastolic BP ≥90mmHg or being on BP-lowering medication. Controlled BP was defined as being on BP-lowering medication with a BP <140/90mmHg. In total, 3,418 were screened, with a mean age of 63.1 years and 56.6% were female. Of all participants, 2,807 (82.1%) had hypertension, of whom 2,505 (89.2%) were aware, and 2,404 (85.6%) were on antihypertensive medication. Of those on medication, 27.5% were taking monotherapy and 41.5% three or more antihypertensive drug classes to control BP. Despite the widespread use of medications only 1,060 (44.1%) of those on treatment had controlled BP, and of all participants with hypertension, 37.8% had controlled BP. Control rates were higher in hypertensive females (41.2%) than males (33.7%), and in hypertensive participants aged ≥50 years (39.2%) than <50 years (23.6%). The MMM campaign in Bulgaria identified a substantial number of participants with untreated or inadequately treated hypertension. The control of high BP was particularly poor among those under 50 years, and in men participating in the study. Dedicated public health initiatives and campaigns aiming at improving hypertension diagnosis and control need to be implemented.