May Measurement Month

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As you are well aware, hypertension has been long recognized as one of the major risk factors for cardiovascular disease and premature deaths worldwide. It is estimated to cause 9.4 million deaths and 7.0% of disability-adjusted life years (DALYs).

In India, it exerts substantial public health burden on cardiovascular health status and the health care system. It is estimated to account for 10.8% of all the deaths and 4.6% of DALYs in the country.

Indian Medical Association is collaborating with Indian Council of Medical Research (ICMR), who in turn, is collaborating with Centre for Chronic Disease Control – WHO Collaborating Centre and Public Health Foundation of India to observe May 2017 as “May Measurement Month”, which is a joint initiative between the International Society of Hypertension and World Hypertension league.

As a part of this international project, it has been decided to monitor the blood pressure of over 25 million people around the globe with India getting a target of 2.5 million in this month.

Indian Medical Association has been assigned, as a participant of this initiative, to ensure that each and every member of the Association monitors the blood pressure of at least 20 patients per day for the whole month starting from 1st May 2017.

Under this project, all patients between 18-65 years of age are to undergo blood pressure monitoring 3 times in one go with a gap of one minute each through mid-left arm sitting position.

A link to download the data collection tool for Android phones is appended below.

We call for the participation of one and all in IMA to achieve the set target for the project as above and raise the IMA flag higher in the international arena.

(Dr KK Aggarwal) (Dr RN Tandon)
National President, IMA Hony Secy Gen, IMA

For Study material, click to download:-
1. Patient_Information_sheet
2. FAQs
3. 10 Tips
4. Project Flyer
5. Matter for Standee
6. Patient Informed Consent format
7. Information sheet for volunteers to use when advising members of the public found to be hypertensive with blood pressure readings of 140/90 or above
8. Measurement card format
9. Printable Excel sheet format for records of persons checked

New ACP/AAFP guidelines on treatment of hypertension in adults older than 60 years

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New clinical practice guidelines developed jointly by the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) for the pharmacologic treatment of hypertension in adults aged 60 years or older have been released.

Published January 17, 2017 in the Annals of Internal Medicine, the guideline includes clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older. The treatment goals should be individualized.

The three recommendations are:

• Treatment should be started if the systolic blood pressure continues to be 150 mm Hg or higher to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events.
• Start or intensify pharmacologic treatment if these patients have a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for recurrent stroke.
• Clinicians should consider initiating or intensifying pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for stroke or cardiac events.

(Source: Annals of Internal Medicine)

Clinic BP measurements may miss many patients with masked hypertension

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According to a new research published in the journal Circulation, around the clock monitoring during daily activity revealed masked, or undetected, high blood pressure among otherwise healthy adults who had normal readings in the clinic.

In this study, researchers compared clinic blood pressure measurements to ambulatory blood pressure monitoring in 888 healthy, middle-aged participants enrolled in the Masked Hypertension Study at Stony Brook University and Columbia University in New York between 2005 and 2012. And 24-hour ambulatory BP monitoring during daily activities revealed undetected high BP among otherwise healthy adults who had normal readings in the clinic.

• 15.7% of study participants with normal clinic BP had masked hypertension based on ambulatory monitoring, regardless of sex, race, or ethnicity.
• Younger, normal-weight participants were more likely than older, overweight participants to have ambulatory blood pressure readings higher than their clinic readings. Based on these findings, the study authors advise doctors to be aware of the fact that normal BP readings in the clinic may not rule out high BP among otherwise healthy patients.

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