撒哈拉以南非洲合并症患者的未控制高血压：系统评价和荟萃分析方案。
Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa: protocol for a systematic review and meta-analysis.
机构信息
Academic Unit of Primary Care (AUPC) and the NIHR Global Health Research Unit on Improving Health in Slums, University of Warwick, Coventry, UK.
Health and Systems for Health Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya.
出版信息
Syst Rev. 2020 Jan 16;9(1):16. doi: 10.1186/s13643-020-1270-7.
BACKGROUND
Uncontrolled hypertension is the most important risk factor and leading cause of cardiovascular diseases. It is predicted that the number of people with hypertension will increase, and a large proportion of this increase will occur in developing countries. The highest prevalence of uncontrolled hypertension is reported in sub-Saharan Africa, and treatment for hypertension is unacceptably low. Hypertension commonly co-exists with comorbidities and this is associated with poorer health outcomes for patients. This review aims to estimate the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa.
METHODS AND ANALYSIS
All published and unpublished studies on the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa will be included. MEDLINE via OVID, Embase, and Web of Science will be searched to identify all relevant articles published from January 2000 to June 2019. Experts in the field will be contacted for unpublished literature, and Open SIGLE will be reviewed for relevant information. No language restriction will be imposed. Two reviewers will select, screen, extract data, and assess the risk of bias while a third reviewer will arbitrate the disagreements. A meta-analysis will be performed on variables that are similar across the included studies. Proportions will be stabilized before estimates are pooled using a random effects model. The presence of publication bias will be assessed using Egger's test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported in accordance with the PRISMA-P protocol guidelines. Results will be stratified by country, comorbidity, and geographic region.
DISCUSSION
This systematic review and meta-analysis is expected to quantify the magnitude of uncontrolled hypertension among patients with certain comorbid conditions in sub-Saharan Africa to guide policies and interventions. This review is registered in PROSPERO International Prospective Register of Systematic reviews CRD42019108218.
背景
未得到控制的高血压是心血管疾病最重要的风险因素和主要病因。预计高血压患者人数将会增加，而这一增长的大部分将出现在发展中国家。在撒哈拉以南非洲，未得到控制的高血压的患病率最高，高血压的治疗率低得令人无法接受。高血压常与合并症同时存在，这会导致患者的健康状况更差。本综述旨在评估撒哈拉以南非洲合并症患者中未得到控制的高血压的患病率。
方法和分析
本研究将纳入所有关于撒哈拉以南非洲合并症患者中未得到控制的高血压患病率的已发表和未发表的研究。将通过 OVID MEDLINE、Embase 和 Web of Science 检索所有 2000 年 1 月至 2019 年 6 月发表的相关文章。将联系该领域的专家以获取未发表的文献，并审查 Open SIGLE 以获取相关信息。本研究不限制语言。两名评审员将选择、筛选、提取数据并评估偏倚风险，而第三名评审员将仲裁分歧。对于具有相似变量的研究，将进行荟萃分析。使用随机效应模型，通过固定效应模型稳定估计值之前，将对比例进行稳定化。将使用 Egger 检验和漏斗图的视觉检查来评估发表偏倚的存在。本系统评价和荟萃分析综述方案将按照 PRISMA-P 方案指南进行报告。结果将按国家、合并症和地理区域进行分层。
讨论
本系统评价和荟萃分析预计将量化撒哈拉以南非洲某些合并症患者中未得到控制的高血压的严重程度，以指导政策和干预措施。本综述已在 PROSPERO 国际前瞻性系统评价注册中心（CRD42019108218）注册。
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