Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, 01 BP 153, Burkina Faso.
Division of Health Research, Faculty of Health & Medicine, Furness Building, Lancaster University, Lancaster, LA1 4YG, UK.
BMC Cardiovasc Disord. 2019 Jul 22;19(1):173. doi: 10.1186/s12872-019-1147-7.
An estimated 55% of older adults in Africa have systemic hypertension, a major risk factor for stroke, heart failure and dementia in the region. The risk factors associated with hypertension in this population group in Africa have not been systematically evaluated. We, therefore, undertook a systematic review to identify these risk factors.
We searched for population-based studies of adults aged ≥50 years living in Africa and reporting an estimate of hypertension and associated risk factors. We included articles published in any language between January 1980 and May 2018 using a comprehensive search strategy. We extracted data including the sample characteristics, prevalence of hypertension and risk factors with their effect sizes.
From an initial 10,719 records, we retained 63 eligible full text articles for review out of which we analyzed 23 studies made up of 19 primary and four multiple publications which had data on risk factors from bivariate or multivariable analysis. The primary studies, published from 2010 to 2018, involved a total of 30,500 participants in 12 different countries with mean ages ranging from 62.7 ± 9 years to 76.9 ± 8.4 years. Through narrative synthesis, we found consistent determinants of hypertension (overweight/obesity and history of stroke), less consistent but frequent determinants (including older age group, female sex and urban residence), inconsistent determinants (including education, wealth index, alcohol intake and physical activity) and nonsignificant covariates (marital status and having health insurance). Overall, the highest adjusted odds ratios were those associated with obesity and history of stroke.
The key determinants of systemic hypertension in older adults in Africa are older age group, overweight/obesity, history of stroke and female sex. Health programmes should promote weight reduction throughout the life course, including during the middle and older age of African adults.
据估计，非洲有 55%的老年人患有系统性高血压，这是该地区中风、心力衰竭和痴呆的主要危险因素。然而，非洲这一人群中与高血压相关的危险因素尚未得到系统评估。因此，我们进行了一项系统评价，以确定这些危险因素。
我们搜索了在非洲生活的年龄≥50 岁的成年人的基于人群的研究，并报告了高血压和相关危险因素的估计值。我们纳入了 1980 年 1 月至 2018 年 5 月期间用综合检索策略发表的任何语言的文章。我们提取了包括样本特征、高血压患病率和危险因素及其效应大小的数据。
从最初的 10719 条记录中，我们保留了 63 篇符合条件的全文文章进行审查，其中我们分析了 23 项研究，这些研究由 19 项原发性研究和 4 项多出版物组成，这些出版物有来自二元或多元分析的危险因素数据。这些原发性研究发表于 2010 年至 2018 年期间，涉及来自 12 个不同国家的 30500 名参与者，平均年龄从 62.7±9 岁到 76.9±8.4 岁不等。通过叙述性综合分析，我们发现高血压的一致决定因素（超重/肥胖和中风史）、不太一致但经常出现的决定因素（包括年龄较大、女性和城市居住）、不一致的决定因素（包括教育、财富指数、饮酒和身体活动）和无统计学意义的协变量（婚姻状况和有医疗保险）。总的来说，与肥胖和中风史相关的调整后比值比最高。
非洲老年人群体中系统性高血压的主要决定因素是年龄较大、超重/肥胖、中风史和女性。卫生规划应在整个生命过程中促进减重，包括在非洲成年人的中年和老年时期。
