Shah Nabi, Shah Qasim, Shah Abdul Jabbar
Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, 22060 Pakistan.
Arch Public Health. 2018 Apr 2;76:20. doi: 10.1186/s13690-018-0265-5. eCollection 2018.
Hypertension has been recognized as a global health concern for developing countries and is scarcely described in many of these countries. In Pakistan, few population-based surveys evaluated the prevalence of hypertension and there is no current nationally representative study (the latest nationwide survey was conducted more than two decades ago). Objective: The goal of the current study was to estimate the pooled prevalence of hypertension in Pakistani population using meta-analysis approach.
We searched the published literature using PubMed, Google and Scopus supplemented by a manual search of bibliographies of retrieved articles for population studies providing estimates on the prevalence of hypertension between 1990 and 2017. Studies were included if they defined hypertension as ≥140/90 mmHg and conducted in adults (≥15 years). From the extracted results, the heterogeneity index of the studies was determined using Chi-squared I2 tests and on the basis of heterogeneity, a fixed or random effect model was used to estimates the pooled prevalence of hypertension. Meta-regression was performed to determine those factor of generating heterogeneity.
Of a total of 1240 articles, 18 studies comprising 42,618 participants met the eligibility criteria. The overall pooled prevalence of hypertension was 26.34% (25.93%, 26.75%). Subgroup analysis showed higher urban prevalence 26.61% (21.80%, 31.42%) than the rural dwellers 21.03% (10.18%, 31.87%). The prevalence by decade in 1990s was 19.55% (18.07%, 21.05%), in 2000s 23.95% (16.60%, 31.30%) and in 2010s 29.95% (24.13%, 35.77%). Similarly, the pooled prevalence was 24.99% (19.70%, 30.28%) in males and 24.76% (16.76%, 32.76%) in females. We recorded high burden of hypertension among the adult Pakistanis when compared to the data published in local and international journals 23.32% (18.9%, 27.74%) and 27.44% (20.97%, 33.91%). We also found differences in the prevalence of hypertension among small, medium and large studies.
Comparing data from previous studies in Pakistan, we found a higher prevalence in urban areas and among males. The prevalence over time is likely to increase faster, further our results underscore the importance of good quality long-term studies that will help to understand hypertension better and implement effective prevention and management programs.
高血压已被公认为发展中国家的一个全球健康问题，而许多此类国家对其描述甚少。在巴基斯坦，很少有基于人群的调查评估高血压患病率，目前也没有具有全国代表性的研究（最新的全国性调查是在二十多年前进行的）。目的：本研究的目的是采用荟萃分析方法估计巴基斯坦人群中高血压的合并患病率。
我们通过PubMed、谷歌和Scopus搜索已发表的文献，并手动搜索检索文章的参考文献，以查找1990年至2017年间提供高血压患病率估计值的人群研究。如果研究将高血压定义为≥140/90 mmHg且在成年人（≥15岁）中进行，则纳入研究。从提取的结果中，使用卡方I²检验确定研究的异质性指数，并根据异质性，使用固定效应模型或随机效应模型估计高血压的合并患病率。进行荟萃回归以确定产生异质性的因素。
在总共1240篇文章中，18项研究（包括42618名参与者）符合纳入标准。高血压的总体合并患病率为26.34%（25.93%，26.75%）。亚组分析显示，城市患病率较高，为26.61%（21.80%，31.42%），高于农村居民的21.03%（10.18%，31.87%）。20世纪90年代的患病率为19.55%（18.07%，21.05%），21世纪00年代为23.95%（16.60%，31.30%），21世纪10年代为29.95%（24.13%，35.77%）。同样，男性的合并患病率为24.99%（19.70%，30.28%），女性为24.76%（16.76%，32.76%）。与当地和国际期刊发表的数据23.32%（18.9%，27.74%）和27.44%（20
