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, African Population and Health Research Center, Nairobi, Kenya.
BMJ Open. 2021 Dec 13;11(12):e045880. doi: 10.1136/bmjopen-2020-045880.
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.
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.
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.
CRD42019108218.
撒哈拉以南非洲（SSA）的未控制高血压负担很高，并且高血压与其他慢性疾病（如肾病、糖尿病等）共存。这是第一项旨在确定 SSA 合并症患者未控制高血压负担的系统评价和荟萃分析。
在 MEDLINE、Embase 和 Web of Science 上进行全面检索，以确定 2000 年 1 月 1 日至 2021 年 6 月 17 日期间发表的所有相关文章。我们纳入了报告 SSA 中报告正在服用抗高血压药物且患有另一种慢性疾病的人群中未控制高血压患病率的研究。对 SSA 中治疗合并症患者的研究进行了随机效应荟萃分析，以获得合并症患者未控制高血压患病率的综合估计值。
共纳入 20 篇文章进行荟萃分析。11 篇文章是关于糖尿病患者的，5 篇文章是关于 HIV 患者的，2 篇文章是关于中风患者的，而慢性肾病和心房颤动各有 1 篇文章。合并症患者未控制高血压的总体患病率为 78.6%（95%CI 71.1%至 85.3%）；I²为 95.9%，范围从中风患者的 73.1%到心房颤动患者的 100.0%。亚组分析表明，各种研究水平特征的未控制高血压患病率存在差异。
这项研究表明 SSA 合并症患者的未控制高血压负担很高。需要采取策略来改善合并症患者的高血压控制。
PROSPERO 注册号：CRD42019108218。
