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Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa : a systematic review and meta-analysis

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Mohamed, Shukri F., Uthman, Olalekan A., Mutua, Martin K., Asiki, G., Abba, Mustapha S. and Gill, Paramjit (2021) Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa : a systematic review and meta-analysis. BMJ Open, 11 (12). e045880. doi:10.1136/bmjopen-2020-045880 ISSN 2044-6055.

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Official URL: https://doi.org/10.1136/bmjopen-2020-045880

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Abstract

Background: The burden of uncontrolled hypertension in sub-Saharan Africa (SSA) is high and hypertension is known to coexist with other chronic diseases such as kidney disease, diabetes among others. This is the first systematic review and meta-analysis to determine the burden of uncontrolled hypertension among patients with comorbidities in SSA. Methods: A comprehensive search was conducted on MEDLINE, Excerpta Medica Database (Embase) and Web of Science to identify all relevant articles published between 1 January 2000 and 17 June 2021. We included studies that reported on the prevalence of uncontrolled hypertension among people in SSA who report taking antihypertensive treatment and have another chronic condition. A random-effects meta-analysis was performed to obtain the pooled estimate of the prevalence of uncontrolled hypertension among patients with comorbid conditions while on treatment across studies in SSA. Results: In all, 20 articles were included for meta-analyses. Eleven articles were among diabetic patients, five articles were among patients with HIV, two were among patients with stroke while chronic kidney disease and atrial fibrillation had one article each. The pooled prevalence of uncontrolled hypertension among patients with comorbidities was 78.6% (95% CI 71.1% to 85.3%); I² 95.9%, varying from 73.1% in patients with stroke to 100.0% in patients with atrial fibrillation. Subgroup analysis showed differences in uncontrolled hypertension prevalence by various study-level characteristics Conclusion: This study suggests a high burden of uncontrolled hypertension in people with comorbidities in SSA. Strategies to improve the control of hypertension among people with comorbidities are needed. PROSPERO registration number: CRD42019108218.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Comorbidity , Hypertension , Hypertension -- Diagnosis -- South Africa, Hypertension -- Prevention -- South Africa, Hypertension -- Epidemiology -- South Africa
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 13 December 2021
Dates:
DateEvent
13 December 2021Published
13 December 2021Available
11 November 2021Accepted
Volume: 11
Number: 12
Article Number: e045880
DOI: 10.1136/bmjopen-2020-045880
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 17 December 2021
Date of first compliant Open Access: 20 December 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
16/136/87National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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