The MMM survey is a cross-sectional opportunistic study of BPs of volunteer adults aged 18 years or more. Over 100 countries were contacted either via those who had collaborated in MMM 2017 or via other national and international hypertension, cardiovascular or renal societies. In each country, one or more national leaders were identified to take the responsibility of acquiring national ethical clearance for the survey (if required) and to identify volunteer staff to set up screening sites and measure BPs. The protocol produced for MMM 2017 (www.maymeasure.com ) was modified slightly on the feedback and input from the 2017 investigators and distributed to all national leaders potentially collaborating in 2018. The website that was produced for MMM in 2017 was updated and included training materials on BP measurement, and campaign promotional materials.
Staff identified in each country set up screening sites in a wide range of locations including hospitals, primary care clinics, indoor and outdoor public places, places of worship, pharmacies, and workplaces. The campaign was promoted internationally by the ISH and the World Hypertension League and locally through television, radio, the media, and social media. Endorsements from sporting, political, and national celebrities were also used.
Volunteers were recruited at local sites using convenience sampling. Having been made aware of the availability of BP screening, those adults who wished to take advantage of the campaign attended one of the available MMM screening sites and were therefore self-referred. The campaign was targeted ideally at those who had not had their BP measured in the previous year, but participants who presented and had been screened more recently were not excluded from the study.
Volunteer staff were trained to measure BP using either automated or manual sphygmomanometers via video recordings housed on the MMM website and via face-to-face on-site training. Standard methods for BP measurement were recommended to include three sitting recordings taken at 1 min intervals, from either the right or left arm, with pulse rate measurements between BP recordings. In 2017 and 2018, ∼14 000 Omron BP devices (Omron Healthcare, Kyoto, Japan) were distributed to MMM sites where insufficient devices were available. In total, 87.3% of readings were taken using Omron devices. Otherwise, locally available devices were used to measure BP with a recommendation to use automated devices where possible.
Prior to BP measurement, a questionnaire was used to collect limited data from each participant. The questionnaire was slightly modified from MMM 2017 to improve clarity and data quality (seeSupplementary material online, Appendix ). Height and weight were recorded where facilities were available or estimated by screenees if not.
Hypertension was defined as a systolic BP of ≥140 mmHg or a diastolic BP of ≥90 mmHg, on the basis of the mean of the second and third BP recording. Those taking antihypertensive medications were also assumed to have hypertension and to be aware of their condition. Among those on treatment, controlled BP was defined as a systolic BP of <140 mmHg and a diastolic BP < 90 mmHg. Screenees found to have untreated or inadequately treated hypertension were provided with evidence-based dietary and lifestyle advice as to how to lower BP (Ten Top Tips: seeSupplementary material online, Appendix ). Advice for further follow-up of their raised BP was also provided, tailored by national investigators based on locally available facilities.
Staff identified in each country set up screening sites in a wide range of locations including hospitals, primary care clinics, indoor and outdoor public places, places of worship, pharmacies, and workplaces. The campaign was promoted internationally by the ISH and the World Hypertension League and locally through television, radio, the media, and social media. Endorsements from sporting, political, and national celebrities were also used.
Volunteers were recruited at local sites using convenience sampling. Having been made aware of the availability of BP screening, those adults who wished to take advantage of the campaign attended one of the available MMM screening sites and were therefore self-referred. The campaign was targeted ideally at those who had not had their BP measured in the previous year, but participants who presented and had been screened more recently were not excluded from the study.
Volunteer staff were trained to measure BP using either automated or manual sphygmomanometers via video recordings housed on the MMM website and via face-to-face on-site training. Standard methods for BP measurement were recommended to include three sitting recordings taken at 1 min intervals, from either the right or left arm, with pulse rate measurements between BP recordings. In 2017 and 2018, ∼14 000 Omron BP devices (Omron Healthcare, Kyoto, Japan) were distributed to MMM sites where insufficient devices were available. In total, 87.3% of readings were taken using Omron devices. Otherwise, locally available devices were used to measure BP with a recommendation to use automated devices where possible.
Prior to BP measurement, a questionnaire was used to collect limited data from each participant. The questionnaire was slightly modified from MMM 2017 to improve clarity and data quality (see
Hypertension was defined as a systolic BP of ≥140 mmHg or a diastolic BP of ≥90 mmHg, on the basis of the mean of the second and third BP recording. Those taking antihypertensive medications were also assumed to have hypertension and to be aware of their condition. Among those on treatment, controlled BP was defined as a systolic BP of <140 mmHg and a diastolic BP < 90 mmHg. Screenees found to have untreated or inadequately treated hypertension were provided with evidence-based dietary and lifestyle advice as to how to lower BP (Ten Top Tips: see
