Blood pressure control has a pivotal role in reducing the incidence and recurrence of stroke. May Measurement Month (MMM), which was initiated in 2017 by the International Society of Hypertension, is the largest global blood pressure screening campaign. We aim to compare MMM participants with and without a previous history of stroke and to investigate associations between national-level estimates of blood pressure management from MMM and premature stroke mortality. In this annual, global, cross-sectional survey, more than 2·5 million volunteers (≥18 years) from 92 countries were screened in May, 2017, and May, 2018. Three seated blood pressure readings and demographic, lifestyle, and cardiovascular disease data were collected. Associations between risk factors and stroke history were analysed with mixed-effects logistic regression, and associations between national-level estimates of blood pressure management and premature stroke mortality based on Global Burden of Disease data were investigated with linear regression. 2 222 399 (88·4%) of 2 515 365 participants had recorded data on a history of stroke, of whom 62 639 (2·8%) reported a previous stroke. Participants with a history of stroke had higher rates of hypertension (77·0% 32·9%, p<0·0001) and of treated (90·2% 57·0%, p<0·0001) and controlled (55·9% 32·4%, p<0·0001) hypertension than those without a history of stroke. A third of participants with a history of stroke had either untreated hypertension or treated but uncontrolled hypertension (blood pressure ≥140/90 mm Hg). Strong positive associations were found between national premature stroke mortality and mean systolic blood pressure (84·3 [95% CI 38·8 to 129·9] years of life lost [YLL] per 100 000 people per mm Hg increase) and the percentage of participants with raised blood pressure (49·1 [22·6 to 75·6] YLL per 100 000 people per 1% increase). Strong negative associations were found between national premature stroke mortality and the percentage of participants with hypertension on treatment (−21·0 [−33·0 to −8·9] YLL per 100 000 people per 1% increase) and with controlled blood pressure (−31·6 [−43·8 to −19·4] YLL per 100 000 people per 1% increase). Blood pressure control remains suboptimal worldwide among people with a history of stroke. National estimates of blood pressure management reflect national premature stroke mortality sufficiently to prompt policy makers to promote blood pressure screening and management. International Society of Hypertension and Servier Pharmaceuticals.

中文翻译：

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中风幸存者的高血压及其与全国过早中风死亡率的关联：来自多国筛查活动的 2·500 万参与者的数据

控制血压对于减少中风的发生和复发具有关键作用。五月测量月（MMM）由国际高血压协会于2017年发起，是全球最大的血压筛查活动。我们的目的是比较有或没有中风病史的 MMM 参与者，并调查 MMM 血压管理的国家级估计值与过早中风死亡率之间的关联。在这项年度全球横断面调查中，来自 92 个国家的超过 2·500 万志愿者（≥18 岁）于 2017 年 5 月和 2018 年 5 月接受了筛查。三项坐着血压读数以及人口、生活方式和心血管疾病收集疾病数据。采用混合效应逻辑回归分析危险因素与卒中病史之间的关联，并采用线性回归研究基于全球疾病负担数据的国家级血压管理估计值与过早卒中死亡率之间的关联。2 515 365 名参与者中的 2 222 399 名 (88·4%) 记录了中风病史数据，其中 62 639 名 (2·8%) 报告了既往中风。有卒中病史的参与者患有高血压 (77·0% 32·9%, p<0·0001)、接受治疗 (90·2% 57·0%, p<0·0001) 和控制 (55 ·9% 32·4%, p<0·0001) 高血压高于无中风病史的人。三分之一有中风病史的参与者患有未经治疗的高血压或已治疗但未控制的高血压（血压≥140/90 mm Hg）。研究发现，全国过早卒中死亡率与平均收缩压（每 10 万人每毫米汞柱增加 84·3 [95% CI 38·8 至 129·9] 年生命损失 [YLL]）和百分比之间存在强正相关关系。血压升高的参与者的比例（每 10 万人每增加 1%，YLL 为 49·1 [22·6 至 75·6]）。研究发现，全国过早卒中死亡率与接受治疗的高血压参与者比例（每 10 万人每增加 1%，−21·0 [−33·0 至 −8·9] YLL）和控制血压的比例之间存在很强的负相关关系（每 10 万人每增加 1%，−31·6 [−43·8 至 −19·4] YLL）。在全球范围内有中风病史的人群中，血压控制仍然不够理想。国家对血压管理的估计充分反映了全国过早卒中死亡率，足以促使政策制定者促进血压筛查和管理。国际高血压协会和施维雅制药公司。