Co-Occurrence of Cardiovascular-Kidney-Metabolic Conditions in the May Measurement Month Global Campaign 2023

Objective: May Measurement Month (MMM) is an annual global blood pressure (BP) screening campaign. This analysis examined the co-occurrence of major cardiovascular-kidney-metabolic (CKM) conditions (including hypertension, diabetes, heart failure, kidney failure, and overweight/obesity) among MMM 2023 participants.Design and method: In 2023, adults (18+ years) were screened opportunistically for BP in 70 countries using a standardised protocol. Three seated BP measurements were taken, and a questionnaire was administered collecting information on demographics and comorbidities. Hypertension was defined as systolic BP >/=140 mmHg and/or diastolic BP >/=90 mmHg based on the mean of the second and third BP readings, or taking BP-lowering medication. Results: In total, 673,304 participants were screened across 70 countries (mean age 47.5±17.3 years; 54.2% female). Of these, 38.4% had hypertension, 7.7% had diabetes, 1.4% had heart failure, 1.1% had kidney failure, and 42.6% were overweight or obese (Body Mass Index, BMI >/= 25 kg/m2). Among those without diabetes, kidney failure or heart failure, 35.4% had hypertension and 47.1% were obese. The majority of those with any of these conditions also had hypertension or were overweight or obese (Figure), a substantially higher percentage than among those without any of these conditions (P<0.0001 for all) (Figure). Overweight or obese individuals similarly showed markedly higher prevalence of hypertension and related CKM conditions compared with those with BMI <25 kg/m2. Hypertension and being overweight or obese were more common in participants with multiple CKM conditions, at 84.6% and 71.2% of those with diabetes and heart failure, 81.4% and 68.8% of those with diabetes and kidney failure, 80.1% and 69.8% of those with kidney failure and heart failure. Conclusions: Hypertension was substantially more common among people with diabetes, heart failure, kidney failure, or overweight/obese, with high rates of co-existence of these co-morbidities consistent with the known clustering of CKM conditions. These findings highlight the importance of BP screening in those with existing comorbidities to address multiple CKM risk factors simultaneously within large-scale public health initiatives such as MMM.